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Urodynamics - Interpretation of basic and advanced: Part 2

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(BQ) Continued part 1, part 2 of the document Urodynamics - Interpretation of basic and advanced has contents: Neurogenic bladder obstruction, iatrogenic female bladder outlet obstruction, pelvic organ prolapse, augmented lower urinary tract, lower urinary tract anomalies,. and other contents. Invite you to refer. | Urodynamics - Interpretation of basic and advanced: Part 2 Bladder Outlet Obstruction: Female Non-neurogenic 8 William D. Ulmer and Elise J.B. De 8.1 Introduction 8.2 ymptoms of Bladder Outlet S Obstruction in Females Bladder outlet obstruction, well-described in males, is less easily characterized in women. The actual prevalence of Classically, outlet obstruction is characterized by feelings of obstructed voiding in women is not well known. The EPIC incomplete emptying, weak stream, intermittency, and hesi- study, consisting of a random sampling of 19,000 adult par- tancy. These are the result of increased resistance to outflow ticipants from Canada and four European countries, revealed between the bladder neck and the urethral meatus. Patients that 19.5 % of the participating women complained of “void- may present with voiding symptoms (slow stream, splaying ing” lower urinary tract symptoms (i.e., intermittency, slow stream, intermittency, hesitancy, straining to void, feeling of stream, straining, and terminal dribble) and 59 % complained incomplete void, or need to immediately re-void) [3]. of storage symptoms (i.e., frequency, nocturia, urgency, urge However, storage symptoms (frequency, nocturia, urge urinary incontinence, stress urinary incontinence, mixed incontinence, urgency) are also common in women with incontinence, and unawares incontinence) [1]. Correlating obstruction [1], resulting in a mixed symptom presentation. voiding/storage symptoms with actual obstruction in women Obstruction may remain subclinical until the patient presents has historically been difficult [2], and women with obstruc- with an episode of urinary retention (e.g., during the postop- tion may additionally present with confounding nonobstruc- erative period for an unrelated surgery), urinary tract infec- tive symptoms. Arriving at a diagnosis of bladder outlet tion, or even renal compromise. obstruction (BOO) in women requires a