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Comparison of the Symptoms With the Urodynamic Test on the Patients With Urinary Incontinence

Year 2009, Volume: 1 Issue: 2, 36 - 42, 01.08.2009

Abstract

Objective: To compare the diagnosis based on the urodynamic test with the outcome of the urodynamic test results on the patients who had the complaints of urinary incontinence anamnesis and to assess the risk factors on the patiens with incontinence. Material and Method: Between December 2000 and April 2007, 206 patients having applied with the complaints of urine leaking to Minestry of Health Istanbul Education and Research Hospital Obstetrics and Gynecology Clinic were classifi ed and compared to their urodynami results. Based on thesesymptoms, thenegativeandpositivepredictiveresultsof thediagnosis were found. Results: Urodynamic study was carried out on the patients having applied with the complaints of stress incontinence, urge incontinence, andmixt incontinence. There were genuine stress incontinence's complaints on 122, urge incontinence's complaints on 38, and mixt incontinence's complaints on 46 of thepatients. Accordingtotherevealed urodynamic results, genuinestress incontinence on 91 patients, overactive bladder on 36 patients, and mixt incontinence on 15 patients were detected. When the patients with genuine stress incontinence were examined according to their types, 18, 50 and 23 of the91 patients diagnosedwithurodynamyhadrespectively type-1, type-2 andtype-3. Theresultsof theurodynamywere compared withsymptomatology. The diagnosis' sensitivity put forward with symptoms 80.2 %, specifi ty 57.3 %, PPD 59.8% , NPD 78.5% for stress incontinence and for overactive bladder, the sensitivity 69.4%, specifi ty 92.3%, PPD 28.2% and NPD 98.7% were found. Conclusion: Symptoms of a patient are weak modifi ers for diagnosing on incontinence. The fi nal diagnosis must be confi rmed withurodynamyforthe patients whoseoperationhasbeen plannedor accuratediagnosis cannotbe reached by simple urogynaecologic tests .

References

  • Sibley GNA . Development in our understanding of detrusor instability. Br J Urol 1997;1; Supp:54-61.
  • McGuire EJ, Lytton B, Kohorn EI, Pepe V. The value of urodynamic testing in stress urinary incontinence. J Urol 1980;124:256-269.
  • Weber AM, Walters MD. Cost-eff ectiveness of urodynamic testing before surgery for women with pelvic organ prolapse and stress urinary incontinence. Am J Obstet Gynecol 2000;183:1338-47 1347.
  • Hastie KJ, Moisey CU. Are urodynamics necessary in female patients presenting with stress incontinence? Br J Urol 1989;63:155-6.
  • Lagro-Janssen AL, Debruyne FM, van Weel C. The value of the patient’s case history in diagnosis urinary incontinence in general practice. Br J Obstet Gynecol 1991;67:569-572.
  • Korda A, Krieger M, Hunter P, Parkin G. The value of clinical syptoms in the diagnosis of urinary incon- tinence in the female. Aust N Z J Obstet Gynaecol 1987;27:149-151.
  • Weidner AC, Myers ER, Visco AG, Cundiff GW, Bump RC. Which women with stress incontinence require urodynamic evaluation? Am J Obstet Gynecol 2001;184:20-27.
  • Cundiff GW, Harris RL, Coates KW, Bump RC. Clinical predictors of urinary incontinence in women. Am J Obstet Gynecol 1997;177:262-267.
  • Jensen JK, Nielsen FR Jr, Ostergard DR. The role of patient history in the diagnosis of urinary incontinance. Obstet Gynecol 1994;83:904-910.
  • Laurikainen E, Kiilholma P. The tension-free va- ginal tape procedure for female urinary incontinence without preoperative urodynamic evaluation. J Am Coll Surg 2003;196:579-583.

Üriner İnkontinanslı Hastalarda Semptomlarla Ürodinami Bulgularının Karşılaştırılması

Year 2009, Volume: 1 Issue: 2, 36 - 42, 01.08.2009

Abstract

Giriş ve Amaç: Üriner inkontinans anemnezi ile başvuran hastalarda, semptomlara dayandırılan tanı ile ürodinamik test sonuçlarını kıyaslamak ve inkontinanslı hastalarda risk faktörlerini değerlendirmek. Gereç ve Yöntem: Aralık 2000 – Nisan 2007 tarihleri arası SB İstanbul Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniğine idrar kaçırma şikayeti ile başvuran 206 hastanın semptomları sınıfl andırıldı veürodinamisonuçlarıilekarşılaştırıldı. Semptomlaradayandırılarak konulan tanının negatif ve pozitif prediktif değerleri bulundu. Bulgular: Stres inkontinans, urge inkontinans, mikst inkontinans şikayetleri ile başvuran 206 hastaya ürodinamik çalışma yapıldı. Hastaların 122'sinde gerçek stresinkontinans, 38'indeurge inkontinans, 46'sındaisemikstinkontinansayönelikşikayetler mevcuttu. Yapılanürodinamisonucuna göre 91 hastada gerçek stres inkontinans, 36 hastada aşırı aktif mesane, 15 hastada mikst inkontinans saptandı. Gerçek stres inkontinanslı GSI hastalar kendi aralarında tiplerine göre bakıldığında; ürodinamik olarak tespit edilen toplam 91 hastanın 18'sı tip-I, 50'si tip II, 23'ü ise tip-III GSI olarak tespit edildi. Semptomatoloji ileürodinamisonuçlarıkarşılaştırıldı. Semptomlarla konulan tanının: stres inkontinans için sensitivitesi %80.2, spesifisitesi %57.3, PPD %59.8, NPD %78.5, aşırı aktif mesane için sensitivitesi %69.4, spesifisitesi %92.3, PPD %65.7, NPD %93.4, mikst tip inkontinans için sensitivitesi %86.6, spesifisitesi %82.7, PPD %28.2, NPD %98.7 olarak bulunmuştur. Sonuç ve Yorum: Hasta semptomları inkontinans tanısı koymada zayıf belirteçlerdir. Operasyonuplanlananveya basitürojinekolojiktestlerletanısı konulamayan hastalarda ürodinamik olarak tanının kesinleştirilmesi gerekir.

References

  • Sibley GNA . Development in our understanding of detrusor instability. Br J Urol 1997;1; Supp:54-61.
  • McGuire EJ, Lytton B, Kohorn EI, Pepe V. The value of urodynamic testing in stress urinary incontinence. J Urol 1980;124:256-269.
  • Weber AM, Walters MD. Cost-eff ectiveness of urodynamic testing before surgery for women with pelvic organ prolapse and stress urinary incontinence. Am J Obstet Gynecol 2000;183:1338-47 1347.
  • Hastie KJ, Moisey CU. Are urodynamics necessary in female patients presenting with stress incontinence? Br J Urol 1989;63:155-6.
  • Lagro-Janssen AL, Debruyne FM, van Weel C. The value of the patient’s case history in diagnosis urinary incontinence in general practice. Br J Obstet Gynecol 1991;67:569-572.
  • Korda A, Krieger M, Hunter P, Parkin G. The value of clinical syptoms in the diagnosis of urinary incon- tinence in the female. Aust N Z J Obstet Gynaecol 1987;27:149-151.
  • Weidner AC, Myers ER, Visco AG, Cundiff GW, Bump RC. Which women with stress incontinence require urodynamic evaluation? Am J Obstet Gynecol 2001;184:20-27.
  • Cundiff GW, Harris RL, Coates KW, Bump RC. Clinical predictors of urinary incontinence in women. Am J Obstet Gynecol 1997;177:262-267.
  • Jensen JK, Nielsen FR Jr, Ostergard DR. The role of patient history in the diagnosis of urinary incontinance. Obstet Gynecol 1994;83:904-910.
  • Laurikainen E, Kiilholma P. The tension-free va- ginal tape procedure for female urinary incontinence without preoperative urodynamic evaluation. J Am Coll Surg 2003;196:579-583.
There are 10 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Ali Ekber Şahin This is me

Remzi Abalı This is me

Aytaç Yüksel This is me

Birtan Boran This is me

H.serpil Bozkurt This is me

İlkbal Temel This is me

Publication Date August 1, 2009
Published in Issue Year 2009 Volume: 1 Issue: 2

Cite

Vancouver Şahin AE, Abalı R, Yüksel A, Boran B, Bozkurt H, Temel İ. Üriner İnkontinanslı Hastalarda Semptomlarla Ürodinami Bulgularının Karşılaştırılması. Maltepe tıp derg. 2009;1(2):36-42.