Is urodynamic evaluation able to change and improve the management of women with idiopathic overactive bladder?

BCKUN: For women with overactive bladder (B), current guidelines recommend the use of urodynamic studies (US) only in complicated cases. This study aimed to investigate whether US can also be helpful in uncomplicated cases. Specific aims of the study were: 1) to evaluate objective benefit and subjective patient satisfaction with tailored treatment based on the US diagnosis compared to the outcomes of the pharmacological treatment only based on the symptoms; 2) to investigate the correlation between symptoms and UDS findings in women with uncomplicated idiopathic B symptoms; 3) to assess the ability of US to modify management decisions in these patients. MTS: Women presenting to our clinic with a history of uncomplicated B symptoms for the past three months or more, and who completed the nternational Consultation on ncontinence Questionnaire-Short Form (CQ-SF), were considered for this study. We proposed US to all participants. n women who accepted US (group 1), management decisions were made on the basis of urodynamic findings and post-treatment evaluation was scheduled at three months. The outcomes of treatments in these patients were compared to the results in women who did not accept US and who received pharmacological treatment symptoms-based (group 2). Objective outcomes were based on completion of a 3-day micturition diary. Subjective outcomes were captured using the Overactive Bladder Questionnaire Short Form (Bq-SF), the atient lobal mpression of mprovement (-) scale, and a patient satisfaction scale. SUTS: total of 680 women were enrolled in the study; 478 underwent US and 202, at the contrary, declined US. In 53.6% of cases, UDS led to modification of the proposed management approach. At the 3-month follow-up, the overall patient satisfaction rate in group 1 and group 2 was 77% and 65.8%, respectively (=0.003). CONCLUSIONS: We showed that OAB management tailored according to the UDS diagnosis results in higher subjective satisfaction if compared with a pharmacological treatment symptoms-based. Our study confirmed a lack of correlation between B symptoms and the urodynamically proven diagnosis of detrusor overactivity (). t also suggested that US can determine the underlying pathophysiology of every woman with B syndrome, whether complicated or uncomplicated, allowing treatment to be appropriately tailored with better results.