Urodynamic and Bladder Diary Factors Predict Overactive Bladderwet in Women: A Comparison With Overactive Bladder-dry

다국어 초록 (Multilingual Abstract)

Purpose: To identify factors predicting the presence of overactive bladder syndrome (OAB)-wet, compared with OAB-dry.
Methods: Between September 2007 and September 2013, the medical records of 623 women with OAB who completed a 3-day bladder diary and underwent urodynamic studies in a medical center were retrospectively reviewed. OAB-wet was diagnosed in patients who complained of at least one episode of urgency incontinence in the previous month; otherwise, OABdry was diagnosed. Multivariable logistic regression analysis was used to predict the presence of OAB-wet.
Results: Age (odds ratio [OR], 1.05; P<0.001), maximal flow rate (Qmax) (OR,1.06; P<0.001), voided volume (OR, 0.996; P=0.001), detrusor pressure at maximal flow rate (PdetQmax) (OR, 1.02; P=0.003), urgency episodes (OR, 1.04; P<0.001) and urodynamic stress incontinence (OR,1.78; P=0.01) were independent predictors for the presence of OAB-wet vs. OABdry.
If we use bladder contractility index as a variable for multivariable logistic regression analysis, bladder contractility index (OR, 1.012; P<0.001) become an independent predictor for OAB-wet.
Conclusions: A smaller bladder capacity and more frequent urgency episodes were predictors of OAB-wet, and the above findings indicate that OAB-wet and OAB-dry might be a continuum of OAB. Old age, high Qmax, high PdetQmax and urodynamic stress incontinence were also predictors for OAB-wet, and the above results reveal that OAB-wet and OAB-dry have partially different clinical and urodynamic features. Further studies might be performed to elucidate whether different treatment strategies between OAB-dry and OAB-wet can improve treatment efficacy.

참고문헌 (Reference)

1 Hsiao SM, "Videourodynamicstudies of women with voiding dysfunction" 7 : 6845-, 2017

2 Sand PK, "Urodynamics and the evaluation of female incontinence: a practical guide" Springer-Verlag 1995

3 Al-Zahrani AA, "Urodynamic findings in women with refractory overactive bladder symptoms" 23 : 75-79, 2016

4 Mohammed A. Al-Ghazo, "Urodynamic Detrusor Overactivity in Patients with Overactive Bladder Symptoms" 대한배뇨장애요실금학회 15 (15): 48-54, 2011

5 Kuo HC, "Urinary nerve growth factor is a better biomarker than detrusor wall thickness for the assessment of overactive bladder with incontinence" 29 : 482-487, 2010

6 Hung MJ, "Urgency is the core symptom of female overactive bladder syndrome, as demonstrated by a statistical analysis" 176 : 636-640, 2006

7 Wu WY, "Twenty-minute pad test : comparison of infusion of 250 ml of water with strong-desire amount in the bladder in women with stress urinary incontinence" 136 : 121-125, 2008

8 Hsiao SM, "The role of serum C-reactive protein in women with lower urinary tract symptoms" 23 : 935-940, 2012

9 Giannantoni A, "Real-life clinical practice of onabotulinum toxin A intravesical injections for overactive bladder wet : an Italian consensus statement" 35 : 299-306, 2017

10 Hsiao SM, "Psychometric assessment of female overactive bladder syndrome and antimuscarinics-related effects" 79 : 428-434, 2014

11 Chassagne S, "Proposed cutoff values to define bladder outlet obstruction in women" 51 : 408-411, 1998

12 Stewart WF, "Prevalence and burden of overactive bladder in the United States" 20 : 327-336, 2003

13 Altman DG, "Practical statistics for medical research" Chapman & Hall 1991

14 Chen YC, "Overactive bladder in Taiwanese women : re-analysis of epidemiological database of community from 1999 to 2001" 31 : 56-59, 2012

15 Balzarro M, "OnabotulinumtoxinA detrusor injection improves female sexual function in women with overactive bladder wet syndrome" 225 : 228-231, 2018

16 Hsiao SM, "Medical treatment of female overactive bladder syndrome and treatment-related effects" 117 : 871-878, 2018

17 Giarenis I, "Is there any association between urodynamic variables and severity of overactive bladder in women with idiopathic detrusor overactivity?" 36 : 780-783, 2017

18 Hashim H, "Is the bladder a reliable witness for predicting detrusor overactivity?" 175 : 191-194, 2006

19 Anger JT, "How dry is"OAB-dry"? Perspectives from patients and physician experts" 188 : 1811-1815, 2012

20 Hsiao SM, "Factors associated with therapeutic efficacy of intravesical onabotulinumtoxinA injection for overactive bladder syndrome" 11 : e0147137-, 2016

21 Hsiao SM, "Factors associated with a better therapeutic effect of solifenacin in patients with overactive bladder syndrome" 33 : 331-334, 2014

22 Cho KJ, "Evaluation of female overactive bladder using urodynamics : relationship with female voiding dysfunction" 41 : 722-728, 2015

23 Hsiao SM, "Evaluation of bladder diary parameters based on correlation with the volume at strong desire to void in filling cystometry" 8 : e69946-, 2013

24 Tubaro A, "Defining overactive bladder: epidemiology and burden of disease" 64 (64): 2-6, 2004

25 Wu WY, "Comparison of 20-minute pad test versus 1-hour pad test in women with stress urinary incontinence" 68 : 764-768, 2006

26 Chen CH, "Clinical and urodynamic effects of baclofen in women with functional bladder outlet obstruction : preliminary report" 42 : 560-565, 2016

27 Abrams P, "Bladder outlet obstruction index, bladder contractility index and bladder voiding efficiency : three simple indices to define bladder voiding function" 84 : 14-15, 1999

28 Hsiao SM, "Autonomic dysfunction and arterial stiffness in female overactive bladder patients and antimuscarinics related effects" 79 : 65-69, 2014

29 Tyagi P, "Association of inflammaging(inflammation + aging)with higher prevalence of OAB in elderly population" 46 : 871-877, 2014

30 Haylen BT, "An International Urogynecological Association(IUGA)/International Continence Society(ICS)joint report on the terminology for female pelvic floor dysfunction" 29 : 4-20, 2010

31 Dokmeci F, "Ambulatory urodynamic monitoring of women with overactive bladder syndrome during single voiding cycle" 212 : 126-131, 2017

32 Nixon A, "A validated patient reported measure of urinary urgency severity in overactive bladder for use in clinical trials" 174 : 604-607, 2005