title: Clinical and video urodynamic characteristics of adult women with dysfunctional voiding.
abstract: OBJECTIVE
  Dysfunctional voiding (DV) is an abnormality of bladder emptying in neurologically normal individuals where the external sphincter activity increases during voiding. This study investigated the clinical presentations and videourodynamic characteristics of adult women with DV.
  
  
  METHODS
  A total of 1605 women with lower urinary tract symptoms (LUTS) were investigated with videourodynamic (VUD) studies from 1997 to 2010. The clinical urinary symptoms and VUD characteristics of DV were compared with a group of urodynamically normal controls. Antimuscarinic or alpha-blocker treatment according to the chief complaint of storage or voiding LUTS was respectively given.
  
  
  RESULTS
  There were 168 women diagnosed with DV. Detrusor overactivity (DO) occurred in 69% of women with DV. Patients with DV had significantly lower cystometric bladder capacity, higher detrusor pressure, lower maximum flow rate, and larger post-void residual volume than the controls. A total of 114 (67.9%) patients had storage symptoms and 54 (32.1%) had voiding symptoms as their chief complaints among those with DV. Among them, urinary frequency (n = 69, 41.1%) was the most common chief complaint, followed by dysuria (n = 53, 32.1%), and urgency incontinence (n = 26, 15.5%). The incidence of urgency incontinence and dysuria were significantly greater than that in the control group, however, the incidence of frequency, urgency, or nocturia showed no significant difference between DV and control groups. The success rates were 41.2% (n = 47) for antimuscarinic therapy and 51.9% (n = 28) for alpha-blocker therapy in patients with storage and voiding LUTS, respectively (p = 0.366).
  
  
  CONCLUSIONS
  DO and storage LUTS commonly occurred in women with DV, suggesting DO could be one of the etiology in the pathophysiology of DV. VUD studies yielded a high diagnostic rate for DV in women with LUTS.
authors.affiliation: Department of Urology, Hualien General Hospital, Hualien, Taiwan.
authors.forename: Yih-Chou
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan. Electronic address: hck@tzuchi.com.tw.
authors.forename: Hann-Chorng
authors.initials: HC
authors.lastname: Kuo
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D053159:Dysuria / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D053158:Nocturia / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D053202:Urinary Incontinence, Urge / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D014554:Urination / Q000502:physiology*; D014555:Urination Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D014563:Urodynamics; D014741:Video Recording
chemical_list: D000317:Adrenergic alpha-Antagonists; D018727:Muscarinic Antagonists
keywords: detrusor overactivity; dysfunctional voiding; video urodynamics; women