Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 4 , Pages 417-421, December 2008

Factors Affecting Voiding Function in Urogynecology Patients

  • Ling-Hong Tseng

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and University of Chang Gung School of Medicine, Tao-Yuan, Taiwan
    • Corresponding Author InformationCorrespondence to Dr Ling-Hong Tseng, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and University of Chang Gung School of Medicine, 5 Fu-Hsing Street, Kwei-Shan, Tao-Yuan 333, Taiwan
  • ,
  • Ching-Chung Liang

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and University of Chang Gung School of Medicine, Tao-Yuan, Taiwan
  • ,
  • Pei-Kwei Tsay

      Affiliations

    • Department of Public Health and Biostatistics Center, University of Chang Gung School of Medicine, Tao-Yuan, Taiwan
  • ,
  • Alex C. Wang

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and University of Chang Gung School of Medicine, Tao-Yuan, Taiwan
  • ,
  • Tsia-Shu Lo

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and University of Chang Gung School of Medicine, Tao-Yuan, Taiwan
  • ,
  • Yi-Hao Lin

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and University of Chang Gung School of Medicine, Tao-Yuan, Taiwan

Accepted 7 March 2008.

Article Outline

SUMMARY 

Objective

Our objective was to assess the impacts of menopause, age and parity on voiding function in urogynecology patients.

Materials and Methods

The medical records of 4,470 patients with urodynamic studies were reviewed at our center between January 1999 and May 2003. Patients with conditions including a prior continence procedure, advanced pelvic prolapse, hysterectomy or neurologic deficits were excluded from our study. Comprehensive medical histories, physical examinations, bladder diaries and results of multi-channel urodynamic testing were analyzed.

Results

The mean age of the 3,161 women enrolled was 50 years, and the mean parity was three. Four urodynamic variables served as voiding parameters: maximum flow rate (Qmax) and post-void residual (PVR) from uroflowmetry, and maximum flow rate (Qmax.p) and detrusor pressure at maximum flow (PdetQmax) from pressure-flow studies. Of the three factors studied (menopause, age, and parity), only parity had a significant impact on uroflowmetry and pressure-flow study results (Qmax, p = 0.007; PVR, p < 0.001; Qmax.p, p = 0.002; PdetQmax, p < 0.001). Twenty-five percent of the patients in our study were diagnosed with voiding dysfunction.

Conclusion

Our results indicated that parity had a significant impact on voiding function in urogynecology patients. Twenty-five percent of patients in our study were diagnosed with voiding dysfunction. The bladder behavior in women after childbirth may be more complex than previously thought, and special attention should be paid to women who suffer from bladder symptoms after childbirth.

Key Words:  age , lower urinary tract , menopause , parturition , urodynamics , voiding function

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Amundsen C , Lau M , English SF , McGuire EJ . Do urinary symptoms correlate with urodynamic findings? . J Urol . 1999;161:1871–1874
  2. Gordon D , Groutz A . Evaluation of female lower urinary tract symptoms: overview and update . Curr Opin Obstet Gynecol . 2001;13:521–527
  3. FitzGerald MP , Brubaker L . Urinary incontinence symptom scores and urodynamic diagnoses . Neurourol Urodyn . 2002;21:30–35
  4. Karram MM , Partoll L , Bilotta V , Angel O . Factors affecting detrusor contraction strength during voiding in women . Obstet Gynecol . 1997;90:723–726
  5. Lemack GE , Baseman AG , Zimmern PE . Voiding dynamics in women: a comparison of pressure-flow studies between asymptomatic and incontinent women . Urology . 2002;59:42–46
  6. Bump RC , Mattiasson A , Bo K , et al.   The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction . Am J Obstet Gynecol . 1996;175:10–17
  7. Abrams P , Cardozo L , Fall M , et al.   The standardisation of terminology of lower urinary tract function . Neurourol Urodyn . 2002;21:167–178
  8. Wang AC , Chen MC . Comparison of tension-free vaginal taping versus modified Burch colposuspension on urethral obstruction: a randomized controlled trial . Neurourol Urodyn . 2003;22:185–190
  9. Lin HH , Torng PL , Sheu BC , Shau WY , Huang SC . Urodynamically age-specific prevalence of urinary incontinence in women with urinary symptoms . Neurourol Urodyn . 2003;22:29–32
  10. Klingele CJ , Carley ME , Hill RF . Patient characteristics that are associated with urodynamically diagnosed detrusor instability and genuine stress incontinence . Am J Obstet Gynecol . 2002;186:866–868
  11. Hunskaar S , Burgio K , Diokno A , Herzog AR , Hjälmås K , Lapitan MC . Epidemiology and natural history of urinary incontinence in women . Urology . 2003;62:16–23
  12. Haylen BT , Ashby D , Sutherst JR , Frazer MI , West CR . Maximum and average urine flow rates in normal male and female populations—the Liverpool nomograms . Br J Urol . 1989;64:30–38
  13. Bhatia NN , Bergman A , Karram M . Changes in urethral resistance after surgery for stress urinary incontinence . Urology . 1989;34:200–204
  14. Yang JM , Huang WC . Factors associated with voiding function in women with lower urinary tract symptoms: a mathematic model explanation . Neurourol Urodyn . 2003;22:574–581
  15. Haylen BT , Law MG , Frazer M , Schulz S . Urine flow rates and residual urine volumes in urogynecology patients . Int Urogynecol J Pelvic Floor Dysfunct . 1999;10:378–383
  16. Klausner AP , Galea J , Vapnek JM . Effect of catheter size on urodynamic assessment of bladder outlet obstruction . Urology . 2002;60:875–880
  17. Chow SN , Huang CC , Lee YT . Demographic characteristics and medical aspects of menopausal women in Taiwan . J Formos Med Assoc . 1997;96:806–811
  18. Robinson D , Cardozo LD . The role of estrogens in female lower urinary tract dysfunction . Urology . 2003;62:45–51
  19. Grady D, Brown JS, Vittinghoff E, Applegate W, Varner E, Snyder T, et al. Postmenopausal hormones and incontinence: the Heart and Estrogen/Progestin Replacement Study . Obstet Gynecol . 2001;97:116–120
  20. Schick E , Tessier J , Bertrand PE , Dupont C , Jolivet-Tremblay M . Observations on the function of the female urethra: I: relation between maximum urethral closure pressure at rest and urethral hypermobility . Neurourol Urodyn . 2003;22:643–647

PII: S1028-4559(09)60009-7

doi:10.1016/S1028-4559(09)60009-7

Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 4 , Pages 417-421, December 2008