Int Neurourol J.  2022 Feb;26(Suppl 1):S1-7. 10.5213/inj.2040482.241.

Diagnostic Value of the Maximum Urethral Closing Pressure in Women With Overactive Bladder Symptoms and Functional Bladder Outlet Obstruction

• Kim SJ
• Choo HJ
• Yoon H

• KMID: 2526658
• DOI: http://doi.org/10.5213/inj.2040482.241

Abstract

Purpose
Overactive bladder (OAB) is observed in women with functional bladder outlet obstruction (FBOO), as are lower urinary tract symptoms (LUTS). Therefore, we evaluated the urodynamic characteristics of women with storage LUTS and FBOO diagnosed by urodynamic studies (UDS).
Methods
Women (n=108) with storage LUTS and FBOO diagnosed by UDS were included in this study. The urodynamic characteristics of women with FBOO were compared with those of women with OAB (n=34) and stress urinary incontinence (SUI, n=78). FBOO was defined as a maximum flow rate (Qmax) < 15 mL/sec, combined with detrusor pressure at a Qmax (PdetQmax) > 20 cm H₂O in a pressure-flow study. The UDS included uroflowmetry, postvoid residual volume determination, a cystometrogram, and a pressure-flow study.
Results
Women with FBOO who had storage symptoms showed a higher PdetQmax and maximum urethral closing pressure (MUCP) than women with OAB and SUI. Interstitial cystitis/bladder pain syndrome (IC/BPS) was observed in 17.6% of women with FBOO. MUCP was significantly higher in women with BOO than in women with BOO and IC/BPS (115.6±27.4 and 96.6±14.1 cm H₂O, P=0.00). The receiver operating characteristic curve analysis showed that the cutoff values of MUCP in women with FBOO compared to women with OAB and SUI were 87 cm H₂O (sensitivity=81.5%, specificity=73.5%) and 36 cm H₂O (sensitivity=92.6%, specificity=84.4%), respectively. The cutoff value of MUCP in women with FBOO compared to women with FBOO and IC/BPS was 92 cm H₂O (sensitivity=85.4%, specificity=78.9%).
Conclusions
MUCP could have predictive value for identifying FBOO in women with complex LUTS.

Keyword

Women; Lower urinary tract symptoms; Urinary bladder, Overactive; Urinary Bladder Neck Obstruction