Bladder outlet obstruction in women: Definition and characteristics

Asnat Groutz, Jerry G. Blaivas, David C. Chaikin

Research output: Contribution to journalArticle

201 Citations (Scopus)

Abstract

The prevalence of bladder outlet obstruction in women is unknown and most probably has been underestimated. Moreover, there are no standard definitions for the diagnosis of bladder outlet obstruction in women. Our study was conducted to define as well as to examine the clinical and urodynamic characteristics of bladder outlet obstruction among women referred for evaluation of voiding symptoms. Bladder outlet obstruction was defined as a persistent, low, maximum 'free' flow rate of <12 mL/s in repeated non- invasive uroflow studies, combined with high detrusor pressure at a maximum flow (p(det.Qmax)) >20 cm H2O) during detrusor pressure-uroflow studies. A urodynamic database of 587 consecutive women identified 38 (6.5%) women with bladder outlet obstruction. The mean age of the patients was 63.9 ± 17.5 years. The mean maximum 'free' flow, voided volume, and residual urinary volume were 9.4 ± 3.9 mL/s, 144.9 ± 72.7 mL, and 86.1 ± 98.8 mL, respectively. The mean P(det.Qmax) was 37.2 ± 19.2 cm H2O. Previous anti- incontinence surgery and severe genital prolapse were the most common etiologies, accounting for half of the cases. Other, less common, etiologies included urethral stricture (13%), primary bladder neck obstruction (8%), learned voiding dysfunction (5%), and detrusor external sphincter dyssynergia (5%). Symptomatology was defined as mixed obstructive and irritative in 63% of the patients, isolated irritative in 29%, and isolated obstructive in other 8%. In conclusion, bladder outlet obstruction in women appears to be more common than was previously recognized, occurring in 6.5% of our patients. Micturition symptoms relevant to bladder outlet obstruction are non-specific, and a full urodynamic evaluation is essential in making the correct diagnosis and formulating a treatment plan. (C) 2000 Wiley-Liss, Inc.

Original languageEnglish (US)
Pages (from-to)213-220
Number of pages8
JournalNeurourology and Urodynamics
Volume19
Issue number3
DOIs
StatePublished - May 22 2000

Fingerprint

Urinary Bladder Neck Obstruction
Urodynamics
Urethral Stricture
Residual Volume
Symptom Assessment
Urination
Prolapse
Ataxia
Databases
Pressure

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Urology

Cite this

Groutz, Asnat ; Blaivas, Jerry G. ; Chaikin, David C. / Bladder outlet obstruction in women : Definition and characteristics. In: Neurourology and Urodynamics. 2000 ; Vol. 19, No. 3. pp. 213-220.
@article{7237a9738f1840eaabab20fb24743876,
title = "Bladder outlet obstruction in women: Definition and characteristics",
abstract = "The prevalence of bladder outlet obstruction in women is unknown and most probably has been underestimated. Moreover, there are no standard definitions for the diagnosis of bladder outlet obstruction in women. Our study was conducted to define as well as to examine the clinical and urodynamic characteristics of bladder outlet obstruction among women referred for evaluation of voiding symptoms. Bladder outlet obstruction was defined as a persistent, low, maximum 'free' flow rate of <12 mL/s in repeated non- invasive uroflow studies, combined with high detrusor pressure at a maximum flow (p(det.Qmax)) >20 cm H2O) during detrusor pressure-uroflow studies. A urodynamic database of 587 consecutive women identified 38 (6.5{\%}) women with bladder outlet obstruction. The mean age of the patients was 63.9 ± 17.5 years. The mean maximum 'free' flow, voided volume, and residual urinary volume were 9.4 ± 3.9 mL/s, 144.9 ± 72.7 mL, and 86.1 ± 98.8 mL, respectively. The mean P(det.Qmax) was 37.2 ± 19.2 cm H2O. Previous anti- incontinence surgery and severe genital prolapse were the most common etiologies, accounting for half of the cases. Other, less common, etiologies included urethral stricture (13{\%}), primary bladder neck obstruction (8{\%}), learned voiding dysfunction (5{\%}), and detrusor external sphincter dyssynergia (5{\%}). Symptomatology was defined as mixed obstructive and irritative in 63{\%} of the patients, isolated irritative in 29{\%}, and isolated obstructive in other 8{\%}. In conclusion, bladder outlet obstruction in women appears to be more common than was previously recognized, occurring in 6.5{\%} of our patients. Micturition symptoms relevant to bladder outlet obstruction are non-specific, and a full urodynamic evaluation is essential in making the correct diagnosis and formulating a treatment plan. (C) 2000 Wiley-Liss, Inc.",
author = "Asnat Groutz and Blaivas, {Jerry G.} and Chaikin, {David C.}",
year = "2000",
month = "5",
day = "22",
doi = "10.1002/(SICI)1520-6777(2000)19:3<213::AID-NAU2>3.0.CO;2-U",
language = "English (US)",
volume = "19",
pages = "213--220",
journal = "Neurourology and Urodynamics",
issn = "0733-2467",
publisher = "Wiley-Liss Inc.",
number = "3",

}

Bladder outlet obstruction in women : Definition and characteristics. / Groutz, Asnat; Blaivas, Jerry G.; Chaikin, David C.

In: Neurourology and Urodynamics, Vol. 19, No. 3, 22.05.2000, p. 213-220.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Bladder outlet obstruction in women

T2 - Definition and characteristics

AU - Groutz, Asnat

AU - Blaivas, Jerry G.

AU - Chaikin, David C.

PY - 2000/5/22

Y1 - 2000/5/22

N2 - The prevalence of bladder outlet obstruction in women is unknown and most probably has been underestimated. Moreover, there are no standard definitions for the diagnosis of bladder outlet obstruction in women. Our study was conducted to define as well as to examine the clinical and urodynamic characteristics of bladder outlet obstruction among women referred for evaluation of voiding symptoms. Bladder outlet obstruction was defined as a persistent, low, maximum 'free' flow rate of <12 mL/s in repeated non- invasive uroflow studies, combined with high detrusor pressure at a maximum flow (p(det.Qmax)) >20 cm H2O) during detrusor pressure-uroflow studies. A urodynamic database of 587 consecutive women identified 38 (6.5%) women with bladder outlet obstruction. The mean age of the patients was 63.9 ± 17.5 years. The mean maximum 'free' flow, voided volume, and residual urinary volume were 9.4 ± 3.9 mL/s, 144.9 ± 72.7 mL, and 86.1 ± 98.8 mL, respectively. The mean P(det.Qmax) was 37.2 ± 19.2 cm H2O. Previous anti- incontinence surgery and severe genital prolapse were the most common etiologies, accounting for half of the cases. Other, less common, etiologies included urethral stricture (13%), primary bladder neck obstruction (8%), learned voiding dysfunction (5%), and detrusor external sphincter dyssynergia (5%). Symptomatology was defined as mixed obstructive and irritative in 63% of the patients, isolated irritative in 29%, and isolated obstructive in other 8%. In conclusion, bladder outlet obstruction in women appears to be more common than was previously recognized, occurring in 6.5% of our patients. Micturition symptoms relevant to bladder outlet obstruction are non-specific, and a full urodynamic evaluation is essential in making the correct diagnosis and formulating a treatment plan. (C) 2000 Wiley-Liss, Inc.

AB - The prevalence of bladder outlet obstruction in women is unknown and most probably has been underestimated. Moreover, there are no standard definitions for the diagnosis of bladder outlet obstruction in women. Our study was conducted to define as well as to examine the clinical and urodynamic characteristics of bladder outlet obstruction among women referred for evaluation of voiding symptoms. Bladder outlet obstruction was defined as a persistent, low, maximum 'free' flow rate of <12 mL/s in repeated non- invasive uroflow studies, combined with high detrusor pressure at a maximum flow (p(det.Qmax)) >20 cm H2O) during detrusor pressure-uroflow studies. A urodynamic database of 587 consecutive women identified 38 (6.5%) women with bladder outlet obstruction. The mean age of the patients was 63.9 ± 17.5 years. The mean maximum 'free' flow, voided volume, and residual urinary volume were 9.4 ± 3.9 mL/s, 144.9 ± 72.7 mL, and 86.1 ± 98.8 mL, respectively. The mean P(det.Qmax) was 37.2 ± 19.2 cm H2O. Previous anti- incontinence surgery and severe genital prolapse were the most common etiologies, accounting for half of the cases. Other, less common, etiologies included urethral stricture (13%), primary bladder neck obstruction (8%), learned voiding dysfunction (5%), and detrusor external sphincter dyssynergia (5%). Symptomatology was defined as mixed obstructive and irritative in 63% of the patients, isolated irritative in 29%, and isolated obstructive in other 8%. In conclusion, bladder outlet obstruction in women appears to be more common than was previously recognized, occurring in 6.5% of our patients. Micturition symptoms relevant to bladder outlet obstruction are non-specific, and a full urodynamic evaluation is essential in making the correct diagnosis and formulating a treatment plan. (C) 2000 Wiley-Liss, Inc.

UR - http://www.scopus.com/inward/record.url?scp=0034017613&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034017613&partnerID=8YFLogxK

U2 - 10.1002/(SICI)1520-6777(2000)19:3<213::AID-NAU2>3.0.CO;2-U

DO - 10.1002/(SICI)1520-6777(2000)19:3<213::AID-NAU2>3.0.CO;2-U

M3 - Article

C2 - 10797578

AN - SCOPUS:0034017613

VL - 19

SP - 213

EP - 220

JO - Neurourology and Urodynamics

JF - Neurourology and Urodynamics

SN - 0733-2467

IS - 3

ER -