Robert Pickard led the peer-review process as the Associate Editor responsible for the paper.
Evidence Based Medicine
Urethral dilatation: Is there any benefit over cystoscopy and distension? A randomized trial in women with overactive bladder symptoms
Version of Record online: 1 MAY 2013
© 2013 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 33, Issue 3, pages 283–288, March 2014
How to Cite
Basu, M., Khullar, V. and Duckett, J. (2014), Urethral dilatation: Is there any benefit over cystoscopy and distension? A randomized trial in women with overactive bladder symptoms. Neurourol. Urodyn., 33: 283–288. doi: 10.1002/nau.22411
Conflict of interest: None.
Contribution to authorship: Basu—study design, data collection and analysis, writing of manuscript. Khullar—study design, writing of manuscript. Duckett—study design, data collection and analysis, writing of manuscript.
- Issue online: 15 MAR 2014
- Version of Record online: 1 MAY 2013
- Manuscript Accepted: 19 MAR 2013
- Manuscript Received: 27 NOV 2012
- West Kent Research Ethics Committee. Grant Number: 08/H1101/97
- Clinicaltrials.gov. Grant Number: NCT00839969
- urethral dilatation;
- overactive bladder;
To evaluate the effect of urethral dilatation (UD) on urgency symptoms in women with overactive bladder (OAB) and voiding dysfunction.
Women with OAB symptoms and a maximum flow rate of less than 15 ml/sec on a volume voided of 200 ml were eligible for entry to the trial. Fifty women with OAB symptoms and a maximum flow rate of less than 15 ml/sec on a volume voided of over 200 ml were randomized to undergo UD plus cystoscopy or cystoscopy alone. All subjects underwent filling and voiding cystometry pre-operatively and at 6 weeks' post-operatively. Subjective outcomes were assessed using the Urgency Perception Scale (UPS) and King's Health Questionnaire at baseline, 6 weeks and 6 months. The primary outcome measure was cure of urgency, defined using the UPS.
Urgency was cured in 10/22 (45%) patients in the UD group and 5/28 (18%) in the non-UD group at 6 weeks (Odds ratio 3.8, 95% confidence interval 1.1–13.8, P = 0.03). Cystometric flow data were available for all patients pre- and post-UD. UD was associated with a significant increase in the flow rate centile from 1.66 to 8.54 (P = 0.01). At 6 months there was no benefit from UD with 4/22 in the UD group cured of urgency and 4/28 in the non-UD group cured (Odds ratio 1.3, 95% confidence interval 0.3–6.1, P = 0.50).
UD confers a significant short-term benefit in cure of urgency over cystoscopy alone, but there is no significant benefit in symptom relief in the long term. Neurourol. Urodynam. 33:283–288, 2014. © 2013 Wiley Periodicals, Inc.