A Predominant Urodynamic Diagnosis Can Hide a Minor One: Study in Non-Neurologic Women

Aims: Voiding dysfunction is a common condition among women. Since voiding and storage symptoms can coexist, evaluation necessitates further investigations with urodynamic studies. Unfortunately, some predominant dysfunction can hide a minor one. The purpose of our study was to retrospectively review urodynamic records of non-neurologic women referred for evaluation of lower urinary tract dysfunction and to explain hidden concomitant urodynamic diagnoses that might have gone unnoticed without a thorough examination. Methods: Urodynamic tracings of 404 consecutive non-neurologic women referred for evaluation of lower urinary tract symptoms were reviewed. Initial urodynamic diagnosis had been proposed according with ICS/IUGA recommendations and a choice of specific urodynamic criteria. Concomitant urodynamic diagnoses were sought by analyzing the values of characteristic parameters which were hidden by predominant phenomenon. Results: Concomitant diagnoses were found for 120 (29.7%) women. Coexistent diagnoses were 48 bladder outlet obstruction, 16 detrusor underactivity and 56 intrinsic sphincter deficiency. That condition was observed for women with predominant diagnosis of detrusor overactivity (63.4%) and detrusor overactivity with impaired contractility (60.0%). Conclusions: Our study show a high prevalence of possible concomitant urodynamic diagnoses for non-neurologic women referred for evaluation of lower urinary tract dysfunction. The practitioner must pay attention to all the parameters measured in order to derive the correct urodynamic diagnosis from which the best management can be proposed.