Extensive urodynamic investigation: interaction among diuresis, detrusor instability, urethral relaxation, incontinence and complaints in women with a history of urge incontinence.
In 72 women with a clinical history of frequency and/or urge incontinence and in whom during filling cystometry nearly no abnormalities were detected, cystometry was repeated not by transurethral filling but under high diuretic conditions (diuresis cystometry). The prevalence and strength of detrusor instability, and the prevalence of incontinence were significantly greater during diuresis cystometry compared to filling cystometry. The experiences of these patients during episodes of instability were similar to those in their own daily environment. Most women with motor urge incontinence on filling or diuresis cystometry are losing urine at detrusor pressures lower than would be expected from urethral closure pressure measurements at rest. Therefore, urethral relaxation may have an important role in the etiology of incontinence. Apparent low amplitude detrusor instability may cause severe incontinence when combined with urethral relaxation. Extensive urodynamic investigations (including diuresis cystometry) will improve the clinical applicability of urodynamics.
van Venrooij
G E
GE
Department of Urology, University Hospital Utrecht, The Netherlands.
Boon
T A
TA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004231:Diuresis; D005260:Female; D006801:Humans; D008875:Middle Aged; D014521:Urethra / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics