Congenital adrenal hyperplasia and lower urinary tract symptoms.
OBJECTIVE
To assess urinary symptoms in adult women with congenital adrenal hyperplasia (CAH), as feminizing surgery in infancy is current standard practice for CAH and one of the indications for surgery is to reduce urinary symptoms.


METHODS
In a case-control study, 19 women with CAH, of whom 16 had had childhood feminizing genital surgery, and age-matched women with no CAH, were evaluated. Subjects and controls completed the Bristol Female Lower Urinary Tract Symptoms (BFLUTS) questionnaire.


RESULTS
Urge incontinence was reported in 13 (68%) patients and three (16%) controls (P = 0.003); stress incontinence was present in 47% and 26%, respectively (P = 0.31). Results from the controls were comparable with those documented in larger studies on normal populations. Nine of the patients felt that their urinary symptoms had an adverse effect on their lives, compared with only one of the controls (P = 0.008).


CONCLUSIONS
Patients with a diagnosis of CAH are more likely to have significant urinary symptoms than normal controls. At present it is not clear whether this is a result of surgery or an effect of CAH. In at least two-thirds of patients surgery did not achieve the objective of reducing urinary symptoms.
Davies
Melissa C
MC
Academic Department of Obstetrics and Gynaecology, University College London, London, UK.
Crouch
Naomi S
NS
Woodhouse
Christopher R J
CR
Creighton
Sarah M
SM
D000293:Adolescent; D000312:Adrenal Hyperplasia, Congenital / Q000150:complications* / Q000601:surgery; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005836:Genitalia, Female / Q000601:surgery; D006801:Humans; D014549:Urinary Incontinence / Q000209:etiology*