The Correlation between Overactive Bladder Symptoms and Urodynamic Findings in Men and Women

Abstract Background: Overactive Bladder (OAB) is defined by the International Continence Society (ICS) as urgency, with or without urge incontinence (UUI), usually with frequency and nocturia, if there is no proven infection or other etiology. Aim of Study: To evaluate the correlation between over-active bladder symptoms (OAB) and urodynamic Detrusor Overactivity (DO) in non neurogenic bladder in both genders. Patients and Methods: We reviewed the records of 202 patients who attended Al-Zahra'a Univesity Hospital between October 2013 and October 2018 with overactive bladder symptoms urgency, with or without urge urinary incontinence usually with frequency and nocturia, with presence or absence of DO in two groups. All patients were subjected to: Full history taking, voiding diary, clinical examination, laboratory investigations, radiological investigations, urodynamic studies (UDS) and cystoscopic biopsies for histopathological exam-ination. Also we evaluate OAB symptoms, urodynamic pa-rameters with histopathological findings. All patients under-went uroflowmetry: The maximum flow rate, average flow rate and voided volume were recorded. Post Voiding Residual urine (PVR) volume was recorded. Cystometry: The intravesi-cal, intra-abdominal, detrusor pressure, first desire to void, strong desire to void, Maximum Cystometric Capacity (MCC), total volume infused, bladder compliance and detrusor over-activity were evaluated. Cystoscopy and random bladder biopsies from all patients and stained with Hematoxylin and Eosin for histopathological examination of smooth muscle, the urothelium, lamina propria, and adventitia. We used another special stain Massons trichrome to visualize collagen and degenerative changes of smooth muscle bundles. Results: Detrusor overactivity DO was diagnosed in (63.36%) 128 OAB patients after urodynamic studies. Of men 42.9% and 36.1% of women with urgency had DO (OAB dry) while 57.1 % of male 63.9% of female patients with urgency and Urge Urinary Incontinence (UUI) were (OAB wet) had DO. Of women 23.8% with no DO were also OAB wet having urodynamic Stress Urinary Incontinence (SUI). Combination of symptoms was more precise in predicting DO in OAB patients. Patchy areas of myohypertrophic and degenerative histological pattern were observed more in group I in both male and female patients. Conclusions: We concluded that there was better correla-tion between OAB symptoms and the urodynamic diagnosis of DO in women than in men, wet OAB more in women than in men in the same group I. Urgency, frequency and UUI in men, nocturia and UUI in women were significantly increased in predicting DO. Combination of objective parameters from the bladder diary, filling cystometry and histopathological findings have a better correlation with the occurrence of DO.