For a study, researchers sought to find independent indicators that could help female patients with trouble voiding distinguish between bladder outlet obstruction (BOO) and detrusor underactivity (DU).
In the study, 918 female patients with lower urinary tract symptoms had their medical records retrospectively reviewed. Out of these, 148 patients with voiding difficulties met the exclusion criteria and were therefore eligible for the trial. According to urodynamic BOO and DU criteria, patients were categorized as having BOO and DU. They examined the symptoms, patient characteristics, free urine flow patterns, and detrusor voiding pressure curves between the 2 groups.
A urodynamic diagnosis of BOO, DU, or unclassified P/F study was made in 42 (28.4%), 37 (25%), or 69 (46.6%) out of 148 patients with a median age of 53 (18-86). According to the results of multivariate logistic regression analysis, the weak urine stream symptom [P=.015 OR = 7.07 CI(1,47-34,0)], the negative provocative stress test [P=.038 OR = 7.32 CI(1,12-47,83)], the continuous detrusor voiding pressure, and the prolonged/tailed shaped free urine flow curve patterns [P<.001 OR = 2,99 CI(1,66-5,38)] were the independent predictors of BOO. The sensitivity and specificity scores for prolonged/tailed to predict BOO were 82.5 and 60%, respectively.
In female patients with voiding difficulty, it was found that the continuous detrusor voiding pressure and the prolonged/tailed free urine flow curve patterns acted as helpful independent indicators for differentiating BOO from DU. Additionally, a negative provocative stress test and the indication of a weak urine stream may be helpful.