Urethral dilatation: Is there any benefit over cystoscopy and distension? A randomized trial in women with overactive bladder symptoms. Issue 3 (1st May 2013)

• Record Type: Journal Article
• Authors: Basu, Maya; Khullar, Vik; Duckett, Jonathan
• Is Part Of: Neurourology and urodynamics. Volume 33:Issue 3(2014:Mar.)
• Page Start: 283
• Page End: 288
• Publication Date: 2013-05-01
• Subjects: Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.22411
• Languages: English
• ISSNs: 0733-2467

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="nau22411-sec-0001" sec-type="section"> <title>Aim</title> <p>To evaluate the effect of urethral dilatation (UD) on urgency symptoms in women with overactive bladder (OAB) and voiding dysfunction.</p> </sec> <sec id="nau22411-sec-0002" sec-type="section"> <title>Methods</title> <p>Women with OAB symptoms and a maximum flow rate of less than 15 ml/sec on a volume voided of 200 ml were eligible for entry to the trial. Fifty women with OAB symptoms and a maximum flow rate of less than 15 ml/sec on a volume voided of over 200 ml were randomized to undergo UD plus cystoscopy or cystoscopy alone. All subjects underwent filling and voiding cystometry pre‐operatively and at 6 weeks' post‐operatively. Subjective outcomes were assessed using the Urgency Perception Scale (UPS) and King's Health Questionnaire at baseline, 6 weeks and 6 months. The primary outcome measure was cure of urgency, defined using the UPS.</p> </sec> <sec id="nau22411-sec-0003" sec-type="section"> <title>Results</title> <p>Urgency was cured in 10/22 (45%) patients in the UD group and 5/28 (18%) in the non‐UD group at 6 weeks (Odds ratio 3.8, 95% confidence interval 1.1–13.8, <italic>P</italic> = 0.03). Cystometric flow data were available for all patients pre‐ and post‐UD. UD was associated with a significant increase in the flow rate centile from 1.66 to 8.54 (<italic>P</italic> = 0.01). At 6 months there was no benefit from UD with 4/22 in the UD group cured of urgency and 4/28 in the non‐UD group cured (Odds ratio 1.3, 95% confidence interval 0.3–6.1, <italic>P</italic> = 0.50).</p> </sec> <sec id="nau22411-sec-0004" sec-type="section"> <title>Conclusion</title> <p>UD confers a significant short‐term benefit in cure of urgency over cystoscopy alone, but there is no significant benefit in symptom relief in the long term. <italic>Neurourol. Urodynam. 33:283–288, 2014</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>