Urodynamic changes in females with refractory lower urinary tract symptoms

Objectives
The study aims to evaluate the urodynamic changes in female patients with refractory lower urinary tract symptoms (LUTSs) and to find the urodynamic changes associated with it. We also aim to diagnose the cause of refractory LUTS as it affects the quality of life.
Patients and methods
The current study included 80 female patients with refractory LUTS who underwent urodynamic evaluation (uroflowmetry, filling and voiding cystometry). Patient with previous anti-incontinence surgery, pregnancy, bladder tumor, bladder stone, haematuria, patients with ureteric stent, partial cystectomy, and cystocele were excluded from this study.
Results
The maximum flow rate () was low in 41.9% of the patients who were complaining of storage symptoms (urgency, frequency, and nocturia). Increased sensation was reported in 67.5% of the patients. There is a strong positive correlation of increased sensation to urgency, frequency, nocturia, and nocturnal enuresis. Low maximum cystometric capacity (MCC) was reported in 52.5% of the patients. There was a strong positive correlation of decreased MCC to urgency, frequency, nocturia, and nocturnal enuresis. Detrusor overactivity (DO) was found in 57.5% of the patients. There was a statistically significant increase in DO among patients who complained of nocturia. Positive Valsalva stress test was seen in 28.6% of the patients with stress urinary incontinence. Respectively, storage symptoms were reported in 95%, voiding symptoms were reported in 5%, and bladder-outlet obstruction was reported in 10% of the patients.
Conclusion
Higher incidence of early sensation, low MCC, and DO is seen in patients with overactive bladder. There is a strong positive correlation between frequency and low . The urodynamic studies are complementary to patients’ symptoms, which can be useful to reach a more precise diagnosis and a more appropriate management plan.