Is there a difference between women with or without detrusor overactivity complaining of symptoms of overactive bladder?
Correspondence: Ilias Giarenis, Department of Urogynaecology, King's College Hospital, Denmark Hill, London SE5 9RS, UK.
What's known on the subject? and What does the study add?
- Overactive bladder syndrome (OAB) is a highly prevalent medical condition, which is linked to the urodynamic observation of detrusor overactivity (DO). Urodynamics detect DO in about half of female patients with OAB.
- Our study detects significant differences between female patients with OAB with and without DO. DO could be considered as a more severe form in the wide OAB spectrum and the two terms should not be used interchangeably. The detected differences should be taken into account in the design of studies for the assessment of new selective or combination treatments of OAB and in the provision of treatment in everyday clinical practice.
- To determine if there are differences between female patients complaining of symptoms of overactive bladder (OAB) with and without detrusor overactivity (DO).
Patients and Methods
- The present study was a cross-sectional study of consecutive women attending a one-stop urodynamic assessment clinic with OAB symptoms.
- The King's Health Questionnaire (KHQ) and a 3-day bladder diary incorporating the Patient's Perception of Intensity of Urgency Scale (PPIUS) were used to assess symptoms and health-related quality of life (HRQoL).
- The participants underwent multichannel urodynamics (UDS) according to the International Continence Society (ICS) recommendations.
- Patients whose symptom of urgency was not reproduced during the laboratory test underwent a 4-h ambulatory UDS test.
- Of the 556 patients who were included in the study, 43% were diagnosed with DO by either laboratory (227/556) or ambulatory UDS (11/39).
- There was no difference between the groups in age, body mass index (BMI), menopausal status or the presence of prolapse.
- Patients with DO had a smaller functional bladder capacity (P < 0.001), higher urgency episode frequency (P < 0.001) and larger maximum and mean urge ratings (P < 0.001).
- No significant differences were found in daytime or nocturnal micturitions between the groups.
- The presence of DO had a more negative impact on the quality of life, with a statistically significant difference between the groups in six of the domains of the KHQ.
- The present study detects objective and subjective differences between female patients with OAB with and without DO.
- Women with DO experience more significant impairment to their quality of life and have a greater degree of bladder dysfunction.