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Voiding dysfunction in women: How to manage it correctly
- Source :
- Arab Journal of Urology
- Publication Year :
- 2013
- Publisher :
- Informa UK Limited, 2013.
-
Abstract
- Introduction Of women aged >40 years, 6% have voiding dysfunction (VD), but the definition for VD in women with respect to detrusor underactivity (DU) and bladder outlet obstruction (BOO) is not yet clear. In this review we address the current literature to define the diagnosis and treatment of VD more accurately. Methods We used the PubMed database (1975–2012) and searched for original English-language studies using the keywords ‘female voiding dysfunction’, ‘detrusor underactivity’, ‘acontractile detrusor’ and ‘bladder outlet obstruction and urinary retention in women’. We sought studies including the prevalence, aetiology, pathogenesis, diagnosis and treatment of female VD. Results In all, 20 original studies were identified using the selected search criteria, and another 45 were extracted from the reference lists of the original papers. All studies were selected according to their relevance to the current topic and the most pertinent reports were incorporated into this review. Conclusion Female VD might be related to DU or/and BOO. Voiding and storage symptoms can coexist, making the diagnosis challenging, with the need for a targeted clinical investigation, and further evaluation by imaging and urodynamics. To date there is no universally accepted precise diagnostic criterion to diagnose and quantify DU and BOO in women. For therapy, a complete cure might not be possible for patients with VD, therefore relieving the symptoms and minimising the long-term complications associated with it should be the goal. Treatment options are numerous and must be applied primarily according to the underlying pathophysiology, but also considering disease-specific considerations and the abilities and needs of the individual patient. The treatment options range from behavioural therapy, intermittent (self-)catheterisation, and electrical neuromodulation and neurostimulation, and up to urinary diversion in rare cases.
- Subjects :
- medicine.medical_specialty
Urology
medicine.medical_treatment
PFS, pressure-flow study
Qmax, maximum urinary flow rate
SNM, sacral neuromodulation
computer.software_genre
PVR, postvoid residual urine volume
PdetQmax, Pdet at Qmax
DV, dysfunctional voiding
DO, detrusor overactivity
Pdet, detrusor pressure
Bladder outlet obstruction
BTA, botulinum toxin A
DM, diabetes mellitus
Clinical investigation
medicine
Women
Intensive care medicine
PVR measurement
Neurostimulation
ApBO, acute prolonged bladder overdistension
VD, voiding dysfunction
PFM, pelvic floor muscles
US, ultrasonography
Urinary retention
business.industry
TVT, tension-free vaginal tape
Urinary diversion
DU, detrusor underactivity
Treatment options
Bladder diary
VCUG, voiding cysto-urethrogram
Neuromodulation (medicine)
POP, pelvic organ prolapse
Pdetmax, maximum Pdet
MUS, mid-urethral sling
IVES, intravesical electrical stimulation
DSD, detrusor sphincter dyssynergia
Etiology
Uroflowmetry
Data mining
medicine.symptom
business
EMG, electromyography
CIC, clean intermittent self-catheterisation
computer
Voiding Dysfunction / Female Urology Review
Subjects
Details
- ISSN :
- 2090598X
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Arab Journal of Urology
- Accession number :
- edsair.doi.dedup.....688b0860db60e4baecf8398068b2a4ca