Dokmeci Fulya, Cetinkaya S Esra, Seval M Murat, Dai Omer
Ankara University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
Ankara University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2017 May;212:126-131. doi: 10.1016/j.ejogrb.2017.03.023. Epub 2017 Mar 18.
OBJECTIVE(S): To present data of standardized ambulatory urodynamic monitoring (AUM) performed in women with overactive bladder syndrome (OAB) and to evaluate the relevance of AUM data with clinical findings of the patients.
Records of women with symptoms of OAB were retrospectively reviewed (n=249). Of women fulfilling the Overactive Bladder Awareness Tool (OAB-V8) with a score ≥8 and the 3-day voiding diary (VD) with a frequency >7/day (n=167), those who underwent urodynamic investigation were selected (n=76). The data of this study were retrieved from the records of Ankara University Cebeci Hospital and based on the AUM findings of single voiding cycle of women with OAB. AUM, which is among the institutionally approved primary urodynamic investigation methods, is performed with LUNA ambulatory monitoring recorder (MMS™) in the clinical setting with a standardized technique, in reproducing lower urinary tract symptoms of women since 2011. The relationship of the urodynamic data with the clinical findings were evaluated.
AUM traces of women (n=76) with OAB revealed 63.1% DO, 64.4% urgency and 77.7% urinary incontinence of which were 14.4% urgency urinary incontinence (UUI), 25% stress urinary incontinence (SUI) and 38.1% mixed urinary incontinence (MUI). OAB patients with DO reported more urinary incontinence episodes/day, nocturia and mixed urinary incontinence in the voiding diary (p<0.04) and had significantly higher irritative symptom bother reflected by the questionnaires (p<0.04). Women with DO were more likely to be postmenopausal (p=0.02) and were found to have more urgency (p<0.001), urgency episodes (p=0.05) and incontinence (urge and mixed) (p<0.001). However, no association was found between the extent of pelvic organ prolapse and the presence of DO.
AUM performed with a standardized technique during single voiding cycle seems to be a reliable method in reproducing symptoms of women with OAB. It provides both clinically relevant findings and objective documentation of urgency which is the main symptom for OAB. The detection of DO according to the ICS definition were also found to be concordant with urodynamicaly observed urgency and urinary incontinence. Objective and subjective clinical findings of OAB were found to be more severe in women with DO.
呈现对膀胱过度活动症(OAB)女性患者进行标准化动态尿动力学监测(AUM)的数据,并评估AUM数据与患者临床症状的相关性。
对有OAB症状的女性患者记录进行回顾性分析(n = 249)。在符合膀胱过度活动症认知工具(OAB-V8)评分≥8且3天排尿日记(VD)频率>7次/天的女性中(n = 167),选取接受尿动力学检查的患者(n = 76)。本研究数据取自安卡拉大学切贝奇医院的记录,基于OAB女性患者单次排尿周期的AUM检查结果。AUM是机构批准的主要尿动力学检查方法之一,自2011年起在临床环境中使用LUNA动态监测记录仪(MMS™),采用标准化技术进行,以重现女性下尿路症状。评估尿动力学数据与临床症状的关系。
OAB女性患者(n = 76)的AUM检查结果显示,63.1%存在逼尿肌过度活动(DO),64.4%有尿急,77.7%有尿失禁,其中14.4%为急迫性尿失禁(UUI),25%为压力性尿失禁(SUI),38.1%为混合性尿失禁(MUI)。有DO的OAB患者在排尿日记中报告的每日尿失禁发作次数、夜尿和混合性尿失禁更多(p < 0.04),问卷反映的刺激性症状困扰明显更严重(p < 0.04)。有DO的女性更可能处于绝经后状态(p = 0.02),且发现有更多尿急(p < 0.001)、尿急发作(p = 0.05)和尿失禁(急迫性和混合性)(p < 0.001)。然而,未发现盆腔器官脱垂程度与DO的存在之间存在关联。
在单次排尿周期采用标准化技术进行的AUM似乎是重现OAB女性患者症状的可靠方法。它既提供了临床相关结果,又提供了尿急这一OAB主要症状的客观记录。根据国际尿控学会(ICS)定义检测到的DO也与尿动力学观察到的尿急和尿失禁一致。发现有DO的OAB女性患者的客观和主观临床症状更严重。