A longitudinal study over 5 to 10 years of clinical outcomes in women with idiopathic detrusor overactivity.
OBJECTIVE
To evaluate the long-term clinical outcome in women with idiopathic detrusor overactivity (IDO) and to identify significant prognostic factors.


METHODS
Longitudinal study incorporating retrospective case note review and a postal questionnaire.


METHODS
Tertiary referral urogynaecology clinic in Australia.


METHODS
Women with a sole urodynamic diagnosis of IDO.


METHODS
Audit of urodynamic records and case notes. Postal questionnaire incorporating validated disease-specific quality-of-life (QoL) instruments.


METHODS
Subjective assessment of overall improvement on a 4-point scale followed by scoring of short forms of the urogenital distress inventory and incontinence impact questionnaire.


RESULTS
One hundred and thirty two women were identified following examination of 1975 consecutive records with 76 (67%) returning questionnaires. Median follow up was 8 years (6-9), and the duration of symptoms was 13 years (9-18). Improvement was achieved in 25 (35%) women. Disease symptoms fluctuated in severity and QoL were worse in nonresponders to therapy (P < 0.0001). Urge incontinence at presentation was associated with treatment failure (P = 0.001) as was nocturia (P = 0.04), but urodynamic variables were not associated with outcome. Only 3 of 46 (6.5%) women not responding to therapy thought that their symptoms would improve with time.


CONCLUSIONS
IDO seldom resolves and fluctuates in severity. Individual response is unpredictable, although the presence of urge incontinence is associated with a significantly worse prognosis.
Morris
A R
AR
Department of Obstetrics and Gynaecology, Royal North Shore Hospital, St Leonards, New South Wales, Australia. alastair.morris@btinternet.com
Westbrook
J I
JI
Moore
K H
KH
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010353:Patient Education as Topic; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000628:therapy*