Forde James C, Davila Jonathan L, Marks Brian K, Epstein Matthew, Tsui Johnson F, Weiss Jeffrey P, Blaivas Jerry G
Deptartment of Urology, Weill Medical College of Cornell University, New York, NY, United States.
Deptartment of Urology, SUNY Downstate Medical School, Brooklyn, NY, United States.
Can Urol Assoc J. 2017 Mar-Apr;11(3-4):E83-E87. doi: 10.5489/cuaj.3962. Epub 2017 Mar 16.
Overactive bladder symptoms (OAB) affect 9-43% of women and are associated with underlying disorders, including pelvic organ prolapse (POP) and stress urinary incontinence (SUI). The aim of this study is to identify urogynecological conditions associated with OAB symptoms.
This prospective, institutional review board-approved study included women referred to a tertiary centre with lower urinary tract symptoms (LUTS). All women completed the self-administered OAB questionnaire (OABSS). Those with an OABSS ≥8, the cutoff, were considered to have OAB symptoms. Patients underwent a history and physical examination (including Baden-Walker prolapse grading and stress test), 24-hour voiding diary, pad test (for urinary incontinence), urinalysis, and uroflow with post-void residual volume. Patients were classified clinically into the following: idiopathic OAB, SUI, POP, bladder outlet obstruction (BOO) neurogenic bladder (NGB), recurrent urinary tract infection (UTI), and miscellaneous.
In total, 148 women met the inclusion criteria with a mean age of 67 years. Only 27% had no comorbid conditions and were considered idiopathic OAB. Associated urogynecological conditions included SUI in 37%, POP in 26%, miscellaneous conditions in 18%, recurrent UTI in 11%, NGB in 9%, and BOO in 8%. Some patients met criteria for more than one category, thus the total is greater than 100%.
In a tertiary care setting, a significant proportion of women with OAB symptoms have underlying conditions that may cause or contribute to their symptoms. Appropriate evaluation is desirable to enhance our understanding of the relationship of these conditions to the diagnosis, treatment, outcomes, and pathophysiology of OAB.
膀胱过度活动症症状（OAB）影响9%至43%的女性，且与包括盆腔器官脱垂（POP）和压力性尿失禁（SUI）在内的潜在疾病相关。本研究的目的是确定与OAB症状相关的泌尿妇科疾病。
这项前瞻性、经机构审查委员会批准的研究纳入了因下尿路症状（LUTS）转诊至三级中心的女性。所有女性均完成了自我管理的OAB问卷（OABSS）。OABSS评分≥8（临界值）的女性被认为有OAB症状。患者接受了病史和体格检查（包括巴登 - 沃克脱垂分级和压力测试）、24小时排尿日记、尿垫试验（用于尿失禁）、尿液分析以及排尿后残余尿量的尿流率检查。患者在临床上被分类为以下几种：特发性OAB、SUI、POP、膀胱出口梗阻（BOO）、神经源性膀胱（NGB）、复发性尿路感染（UTI）以及其他。
共有148名女性符合纳入标准，平均年龄为67岁。只有27%没有合并症，被认为是特发性OAB。相关的泌尿妇科疾病包括37%的SUI、26%的POP、18%的其他疾病、11%的复发性UTI、9%的NGB以及8%的BOO。一些患者符合不止一种类别的标准，因此总数超过了100%。
在三级医疗环境中相当一部分有OAB症状的女性存在可能导致或促成其症状的潜在疾病。进行适当的评估有助于增强我们对这些疾病与OAB的诊断、治疗、结局及病理生理学之间关系 的理解。
