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• W1972901435 abstract "No AccessJournal of UrologyAdult urology1 Sep 2007Urodynamic Obstruction in Women With Stress Urinary Incontinence—Do Nonintubated Uroflowmetry and Symptoms Aid Diagnosis? Giovanni Luca Gravina, Alessia Mariagrazia Costa, Giuseppe Paradiso Galatioto, Piero Ronchi, Andrea Tubaro, and Carlo Vicentini Giovanni Luca GravinaGiovanni Luca Gravina Equal study contribution. More articles by this author , Alessia Mariagrazia CostaAlessia Mariagrazia Costa Equal study contribution. More articles by this author , Giuseppe Paradiso GalatiotoGiuseppe Paradiso Galatioto More articles by this author , Piero RonchiPiero Ronchi More articles by this author , Andrea TubaroAndrea Tubaro More articles by this author , and Carlo VicentiniCarlo Vicentini More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2007.05.057AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We estimated the prevalence of urodynamic obstruction in women with stress urinary incontinence and determined which clinical indicator (nonintubated uroflowmetry or urinary symptoms) better predicts urodynamic obstruction. Materials and Methods: From December 2004 to June 2005, 101 women with urodynamic stress urinary incontinence were enrolled. Adjunctive lower urinary tract symptoms were also observed. Of 101 women with stress urinary incontinence 27 had abnormal and 74 had normal nonintubated uroflowmetry. Normal nonintubated uroflowmetry was defined as a bell-shaped curve with maximum flow more than 15 ml per second and post-void residual urine less than 50 ml. Urodynamic obstruction was diagnosed based on maximum urine flow less than 12 ml per second and maximum detrusor pressure at maximum flow more than 25 cm H2O. Results: In our stress urinary incontinence population the prevalence of urodynamic obstruction was 15.7%. In urodynamically obstructed women storage symptoms were most common (56.3%), while voiding and post-micturition symptoms were less common (31.3% and 6%, respectively). A good correlation between abnormal nonintubated uroflowmetry and urodynamic obstruction (phi = 0.718, p <0.0001) was found. lower urinary tract symptoms correlated weakly with urodynamic obstruction. The diagnostic performance of abnormal nonintubated uroflowmetry for predicting urodynamic obstruction showed that it had relatively low positive predictive value (51.8%) with high negative predictive value (97.3%), sensitivity (87.5%) and specificity (84.1%). The diagnostic performance of lower urinary tract symptoms was weak. Conclusions: Our study confirms the coexistence of obstruction and stress urinary incontinence. In this population abnormal nonintubated uroflowmetry cannot always confirm the presence of urodynamic obstruction and complete urodynamic study might be indicated. Conversely normal nonintubated uroflowmetry seems to accurately predict normal urodynamic study and might render the execution of this test not essential. Symptoms represent a poor clinical indicator of voiding disorder. References 1 : Definition of overactive bladder and epidemiology of urinary incontinence. Urology, suppl1997; 50: 4. Google Scholar 2 : Urodynamics. In: Incontinence. Edited by . Plymouth, United Kingdom: Health Publication Ltd2002: 317. Google Scholar 3 : Urodynamically defined stress urinary incontinence and bladder outlet obstruction coexist in women. J Urol2004; 171: 757. Link, Google Scholar 4 : The symptom of voiding dysfunction: its predictive value in the diagnosis of emptying function disorder. Urogynaecologia I J1999; 2: 71. Google Scholar 5 : Intra and inter-observer variations in classification of urinary flow curve patterns. Neurourol Urodyn1999; 9: 535. Google Scholar 6 : Degree of bother caused by nocturia in women. Neurourol Urodyn2004; 23: 130. Google Scholar 7 : Treatment of urge-predominant mixed urinary incontinence with tolterodine extended release: a randomized, placebo-controlled trial. Urology2004; 64: 269. Google Scholar 8 : Analysis of the standardization of terminology of lower urinary tract dysfunction: report from the Standardisation Sub-Committee of the International Incontinence Society. Neurourol Urodyn2002; 21: 167. Google Scholar 9 : Refining Diagnosis of anatomic female bladder outlet obstruction: comparison of pressure-flow study parameters in clinically obstructed women with those of normal controls. Urology2004; 64: 675. Google Scholar 10 : Uroflowmetry in female voiding disturbances. Neurourol Urodyn2003; 22: 569. Google Scholar 11 : Predictability of urodynamic findings based on urogenital distress inventory-6 questionnaire. Urology1999; 53: 461. Google Scholar 12 : The ICS-“BPH” study: the psychometric validity and reliability of the ICSmale questionnaire. Br J Urol1996; 77: 554. Google Scholar 13 : Relative bladder outlet obstruction. J Urol2002; 168: 565. Link, Google Scholar 14 : Proposed cutoff values to define bladder outlet obstruction in women. Urology1998; 51: 408. Google Scholar 15 : Voiding dynamics in women: a comparison of pressure flow studies between asymptomatic and incontinent women. Urology2002; 59: 42. Google Scholar 16 : Symptom and quality of life assessment. In: Incontinence: 3rd International Consultation of Incontinence. Edited by . Plymouth, United Kingdom: Health Publications Ltd2005: 519. Google Scholar Departments of Surgery, G. Mazzini Hospital, Teramo and University of L’Aquila, L’Aquila and Departments of Urology, Sant’Andrea Hospital and 2nd School of Medicine, La Sapienza University of Rome, Rome, Italy© 2007 by American Urological AssociationFiguresReferencesRelatedDetails Volume 178Issue 3September 2007Page: 959-964 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsurinary incontinencebladderurinary bladder neck obstructionstressfemaleMetricsAuthor Information Giovanni Luca Gravina Equal study contribution. More articles by this author Alessia Mariagrazia Costa Equal study contribution. More articles by this author Giuseppe Paradiso Galatioto More articles by this author Piero Ronchi More articles by this author Andrea Tubaro More articles by this author Carlo Vicentini More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W1972901435 title "Urodynamic Obstruction in Women With Stress Urinary Incontinence—Do Nonintubated Uroflowmetry and Symptoms Aid Diagnosis?" @default.
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