Skip to main content

Advertisement

Log in

The effect of urethral dilatation on pressure flow studies in women with voiding dysfunction and overactive bladder

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The aim of this study was to assess whether urethral dilatation (UD) leads to changes in pressure flow parameters in women with voiding dysfunction (VD) and whether this correlates with improvement in overactive bladder symptoms (OAB).

Methods

Forty three women with drug-resistant OAB and VD underwent cystoscopy and UD. Pressure flow studies were undertaken at 6 weeks with further follow-up at 6 months. Any significant changes in pressure flow parameters after UD were evaluated.

Results

Thirty three percent of the participants reported subjective improvement. This was maintained at 6 months in 19%. Improvement in OAB was associated with an increase in maximum flow rate centile (p = 0.02) and a decrease in detrusor pressure at maximum flow (p = 0.03). Thirteen percent developed urodynamic stress incontinence.

Conclusions

Thirty three percent of women with drug-resistant OAB have a short-term improvement following UD. Improvement is associated with an increased maximum flow rate centile and a decreased detrusor pressure at maximum flow. The long-term improvement rate is poor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Dwyer P, Desmedt E (1994) Impaired bladder emptying in women. Aust N Z J Obstet Gynaecol 34:73–78

    Article  PubMed  CAS  Google Scholar 

  2. Irwin D, Milsom I, Hunskaar S et al (2006) Population based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 50:1306–1314

    Article  PubMed  Google Scholar 

  3. Haylen B, Krishnan S, Schulz S et al (2007) Has the true prevalence of voiding difficulty in urogynaecology patients been underestimated? Int Urogynecol J Pelvic Floor Dysfunc 18:53–56

    Article  Google Scholar 

  4. Groutz A, Blaivas J (2002) Non-neurogenic female voiding dysfunction. Curr Opin Urol 12:311–316

    Article  PubMed  Google Scholar 

  5. Lemack G, Foster B, Zimmern P (1999) Urethral dilatation in women: a questionnaire based analysis of practice patterns. Urology 54:37–43

    Article  PubMed  CAS  Google Scholar 

  6. Kelleher C, Cardozo L, Khullar V, Salvatore S (1997) A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol 104:1374–1379

    PubMed  CAS  Google Scholar 

  7. Dietz HP, Haylen B (2005) Symptoms of voiding dysfunction: what do they really mean? Int Urogynecol J Pelvic Floor Dysfunc 16:52–55

    Article  CAS  Google Scholar 

  8. Groutz A, Blaivas J, Chaikin D (2000) Bladder outlet obstruction in women: definition and characteristics. Neurourol Urodyn 19:213–220

    Article  PubMed  CAS  Google Scholar 

  9. Carson C, Segura J, Osborne D (1980) Evaluation and treatment of the female urethral syndrome. J Urol 124:609–610

    PubMed  CAS  Google Scholar 

  10. Rutherford A, Hinshaw K, Essenhigh D, Neal D (1988) Urethral dilatation compared with cystoscopy alone in the treatment of women with recurrent frequency and dysuria. Br J Urol 61:500–504

    Article  PubMed  CAS  Google Scholar 

  11. Santucci R, Payne C, Saigal C, Urologic Diseases in America Project (2008) Office dilation of the female urethra: a quality of care problem in the field of urology. J Urol 180:2068–2075

    Article  PubMed  Google Scholar 

  12. Thomas AW, Abrams P (2000) Lower urinary tract symptoms, benign prostatic obstruction and the overactive bladder. BJU Int 85(Suppl 3):57–68

    PubMed  Google Scholar 

  13. Duckett J, Basu M (2007) The predictive value of pre-operative pressure flow studies in the resolution of detrusor overactivity and overactive bladder after tension-free vaginal tape insertion. BJU Int 99:1439–1442

    Article  PubMed  Google Scholar 

  14. Kayigil O, Metin A, Atmaca A (2007) Obstructive urodynamic findings in idiopathic detrusor overactivity. Int Urol Nephrol 39:445–448

    Article  PubMed  Google Scholar 

  15. Karram M, Partoll L, Bilotta B, Angel O (1997) Factors affecting detrusor contraction strength during voiding in women. Obstet Gynecol 90:723–726

    Article  PubMed  CAS  Google Scholar 

  16. Sze E, Miklos J, Karram M (1996) Voiding after Burch colposuspension and effects of concomitant pelvic surgery: correlation with pre-operative voiding mechanism. Obstet Gynecol 88:564–567

    Article  PubMed  CAS  Google Scholar 

  17. Stanton S, Ozsoy C, Hilton P (1983) Voiding difficulties in the female: prevalence, clinical and urodynamic review. Obstet Gynecol 61:144–147

    PubMed  CAS  Google Scholar 

  18. Chassagne S, Bernier P, Haab F, Roehrborn C, Reisch J, Zimmern P (1998) Proposed cut-off values to define bladder outlet obstruction in women. Urology 51:408–411

    Article  PubMed  CAS  Google Scholar 

  19. Balivas J, Groutz A (2000) Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn 19:553–560

    Article  Google Scholar 

  20. Uehling D (1978) The normal caliber of the female urethra. J Urol 120:176–177

    PubMed  CAS  Google Scholar 

  21. Robinson D, Anders K, Cardozo L, Bidmead J, Dixon A, Balmforth J, Rufford J (2003) What do women want? Interpretation of the concept of cure. J Pelvic Med Surg 9:273–277

    Article  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jonathan Duckett.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Basu, M., Duckett, J. The effect of urethral dilatation on pressure flow studies in women with voiding dysfunction and overactive bladder. Int Urogynecol J 20, 1073–1077 (2009). https://doi.org/10.1007/s00192-009-0904-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-009-0904-z

Keywords

Navigation