Akademik Veri Yönetim Sistemi
Turk Uroloji Dergisi, cilt.30, sa.4, ss.451-456, 2004 (SCI-Expanded)
Introduction: The storage and timely expulsion of urine were made by the lower urinary tract. Urinary incontinence occurs when the lower urinary tract fails to maintain its storage function. Urinary incontinence is a storage symptom. However, this symptom does not always imply pure storage disturbances. Therefore, urinary incontinence in women is often evaluated by cystometry only ignores the pressure flow study. In this study, we aimed to evaluate the importance of pressure flow study in women with incontinence Materials and Methods: Between September 1998 and October 2003, we retrospectively reviewed an urodynamic records of 264 consecutive women referred for the evaluation of incontinence symptom. Patients with a history of neurological disease, stage 4 pelvic prolapse and can not micturate during pressure flow study were excluded from study. There are a total of 85 incontinent women who met the inclusion criteria. Cystometry and pressure flow studies were performed using standard techniques. A diagnosis was made in each case based on cystometry findings, while any additional diagnoses when applicable were based on the pressure flow study. The provocative stress test significantly distinguishes stress incontinence from other types. Results: Mean patient age was 55.4 years (range 32-77). The incontinent women were classified as the patients who had stress (41.2%), urge (31.8%) and mixed incontinence (27%), according to their history, physical examination and urodynamic test results. Commonly seen cystometric findings were detrusor overactivity in 21 cases (24.7%), urgency in 17 (20%) and stress incontinence 15 (17.6%). On the other hand in 18 cases (21.2%) cystometry were found normal. Pressure flow study diagnosis of voiding abnormalities was made in 14 women (16.5% of the incontinent patients), including 4 dysfunctional voiding, 3 post-void residual urine over than 100 ml, 2 bladder outlet obstruction, 2 obstruction due to stage 2 to 3 cystocele, 2 obstruction after incontinence surgery and 1 impaired contractility. Impaired compliance and post-void residual urine volume were significantly higher (p<0.01), detrusor pressure at peak urinary flow was significantly lower in women with voiding abnormalities (p<0.001). No differences in age, detrusor overactivity, bladder capacity and detrusor pressure at maximum urinary flow were identified between women with and without voiding abnormalities. Conclusion: Female patients with urinary incontinence may also have voiding abnormalities. Therefore, women with urinary incontinence, pressure flow study should be undergone with cystometry in order to reveal diagnosis of possible voiding abnormalities.