Bladder Outlet Obstruction in Female Patients with Lower Urinary Tract Symptom

Im, Jae Gyun; Kim, Joon Chul; Seo, Seong Il; Park, Yong Hyun; Hwang, Tae Kon

Abstract

PURPOSE: The prevalence of female bladder outlet obstruction(BOO) is not well known and the diagnostic criteria is uncertain. We attempted to find out the features of urodynamic and clinical findings of bladder outlet obstruction in female patients with lower urinary tract symptom.
MATERIALS AND METHODS
A total of 251 patients who were referred to urodynamic study for lower urinary tract symptom was available for analysis. Patients who had previous pelvic surgery history or neurologic causes were excluded. History taking, physical examination, voiding diary, urodynamic study were performed. Urodynamic study consisted of free uroflow, urethral pressure profile, cystometry, and pressure flow studies. The criteria of bladder outlet obstruction was peak flow rate at free uroflow less than 12ml/s and detrusor pressure at a maximum flow rate of more than 20cmH2O. Among the patients who were revealed as stress urinary incontinence, but with no other abnormalities at urodynamic study, 30 served as the controls.
RESULTS
In 251 patients, 42(16.7%) were BOO patients. There were no significant differences in the clinical features of the two groups, such as age, parity, surgical history. In the urodynamic study, the first voiding sense and maximal bladder capacity were similar in the two groups. Peak flow rate was 24.0+/-10.9ml/s in the control and 7.9+/-1.7ml/s in BOO, the detrusor pressure of maximum flow was 25.8+/-10.4cmH2O and 62.6+/-33.1cmH2O, maximal urethral closing pressure was 55.3+/-20.3cmH2O and 79.5+/-46.8cmH2O, voiding volume was 377.2+/-85.0ml/s and 281.0+/-104.3ml/s, and residual volume was 19.3+/-76.9ml/s and 48.7+/-80.0ml/s, respectively.
CONCLUSIONS
Among the female patients who had low urinary tract symptoms, numerous patients were revealed as BOO. BOO must be considered for female patients who have low urinary tract symptoms, and urodynamic studies may play an important role for the diagnosis and treatment of BOO.