Understanding lower urinary tract function in women soon after bladder neck surgery
✍ Scribed by Richard C. Bump; W. Glenn Hurt; Denise M. Elser; James P. Theofrastous; W. Allen Addison; J. Andrew Fantl; Donna K. McClish
- Publisher
- John Wiley and Sons
- Year
- 1999
- Tongue
- English
- Weight
- 40 KB
- Volume
- 18
- Category
- Article
- ISSN
- 0733-2467
No coin nor oath required. For personal study only.
✦ Synopsis
The aim of this work was to correlate anatomic and urodynamic measures with function following bladder neck surgery. Eighty-seven women who underwent bladder neck surgery at two tertiary academic medical centers in the southeastern U.S. were studied in this prospective outcomes analysis. Preoperative and 6-week and 6-month postoperative status was assessed with urodynamic testing, physical examination, and condition-specific quality of life instruments. Correlations of dynamic urethral obstruction (quantified by pressure transmission ratio, PTR, determinations) and urethral support (quantified by urethral axis measurements) with functional status were determined. At 6 weeks, 50% of the subjects with inadequate dynamic obstruction (PTR < 90%) had genuine stress incontinence (GSI) compared to 5% of those with PTR Ն90% (P ס .00002). Of those with excessive obstruction (PTR > 110%), 32% had detrusor instability (DI) and 47% had emptying phase dysfunction (EPD) compared to 6% and 24%, respectively, of those with PTR Յ 110% (P ס .006 and P ס .04). At 6 months, subjects with excessive obstruction were more likely to have EPD than other subjects (75% vs. 27%, P ס .001). Those with optimal dynamic obstruction (PTR Ն 90% but Յ 110%) were more likely to have normal function (no GSI,