A Novel Predictive Model of Detrusor Overactivity Based on Clinical Symptoms and Non-invasive Test Parameters in Female Patients with Lower Urinary Tract Symptoms

Overview

Journal Int Urogynecol J

Publisher Springer

Specialties Gynecology & Obstetrics
Urology

Date 2024 Sep 19

PMID 39297987

Authors

Yu Cheng

Taicheng Li

Xiaoyu Wu

Guanghui Du

Shengfei Xu

Affiliations

Soon will be listed here.

Abstract

Introduction And Hypothesis: This study was aimed at investigating non-invasive indicators correlated with detrusor overactivity (DO) and at developing a prediction model for DO by reviewing clinical and urodynamic data of female patients.

Methods: We retrospectively enrolled 1,084 female patients who underwent a urodynamic study (UDS) at Tongji Hospital between September 2011 and April 2021. Associated factors and the independent prediction factors of DO were demonstrated by univariate and multivariate analysis. A non-invasive prediction model of DO was developed and validated by applying these data.

Results: A total of 194 patients (17.9%) were classified as having DO. A logistic regression of a multivariate nature showed that DO risk factors were independent of age, nocturia, urgency, urgency urinary incontinence (UUI), and the lack of stress urinary incontinence (SUI). The DO prediction model had good performance, with an area under the curve of 0.880 (95% CI 0.826-0.933), which was verified by urodynamic data of patients in Tongji Hospital to be 0.818 (95% CI 0.783-0.853). An outstanding correspondence between the anticipated probability and the observed frequency was revealed by the calibration curve. Decision curve analysis demonstrated that clinical net benefit can be obtained by applying the DO prediction model when the DO risk probability was between 8 and 97%.

Conclusions: A non-invasive prediction model of DO was developed and validated using clinical and urodynamic data. Five independent factors associated with DO were identified: age, nocturia, urgency, UUI, and SUI. This prediction model can contribute to assessing the risk of female DO without the need for invasive urodynamic studies.

References

Irwin D, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S . Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006; 50(6):1306-14. DOI: 10.1016/j.eururo.2006.09.019. View

Coyne K, Sexton C, Irwin D, Kopp Z, Kelleher C, Milsom I . The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU Int. 2008; 101(11):1388-95. DOI: 10.1111/j.1464-410X.2008.07601.x. View

Kannan H, Radican L, Turpin R, Bolge S . Burden of illness associated with lower urinary tract symptoms including overactive bladder/urinary incontinence. Urology. 2009; 74(1):34-8. DOI: 10.1016/j.urology.2008.12.077. View

Aydin S, Arioglu Aydin C, Ersan F . Prediction of Mid-Urethral Sling Failure with Clinical Findings and Urodynamics. Low Urin Tract Symptoms. 2017; 9(2):89-93. DOI: 10.1111/luts.12121. View

Smith A, Bevan D, Douglas H, James D . Management of urinary incontinence in women: summary of updated NICE guidance. BMJ. 2013; 347:f5170. DOI: 10.1136/bmj.f5170. View

Gonzalez G, Dallas K, Arora A, Kobashi K, Anger J . Underrepresentation of Racial and Ethnic Diversity in Research Informing the American Urological Association/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Stress Urinary Incontinence Guideline. Urology. 2021; 163:16-21. DOI: 10.1016/j.urology.2021.08.038. View

Palaiologos K, Annappa M, Grigoriadis G . Correlation Between Urodynamic and Clinical Diagnoses in Classifying the Type of Urinary Incontinence in Women. Cureus. 2019; 11(10):e6016. PMC: 6881091. DOI: 10.7759/cureus.6016. View

van Leijsen S, Hoogstad-van Evert J, Mol B, Vierhout M, Milani A, Heesakkers J . The correlation between clinical and urodynamic diagnosis in classifying the type of urinary incontinence in women. A systematic review of the literature. Neurourol Urodyn. 2011; 30(4):495-502. DOI: 10.1002/nau.21047. View

Chung S, Liao C, Chen Y, Kuo H . Urgency severity scale could predict urodynamic detrusor overactivity in patients with overactive bladder syndrome. Neurourol Urodyn. 2011; 30(7):1300-4. DOI: 10.1002/nau.21057. View

10.

Haylen B, Yang V, Logan V, Husselbee S, Law M, Zhou J . Does the presenting bladder volume at urodynamics have any diagnostic relevance?. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 20(3):319-24. DOI: 10.1007/s00192-008-0775-8. View

11.

Latthe P, Middleton L, Rachaneni S, McCooty S, Daniels J, Coomarasamy A . Ultrasound bladder wall thickness and detrusor overactivity: a multicentre test accuracy study. BJOG. 2017; 124(9):1422-1429. DOI: 10.1111/1471-0528.14503. View

12.

Vella M, Robinson D, Cardozo L, Srikrishna S, Cartwright R . Predicting detrusor overactivity using a physician-based scoring system. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19(9):1223-7. DOI: 10.1007/s00192-008-0607-x. View

13.

Giarenis I, Musonda P, Mastoroudes H, Robinson D, Cardozo L . Can we predict detrusor overactivity in women with lower urinary tract symptoms? The King's Detrusor Overactivity Score (KiDOS). Eur J Obstet Gynecol Reprod Biol. 2016; 205:127-32. DOI: 10.1016/j.ejogrb.2016.07.495. View

14.

Schafer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A . Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn. 2002; 21(3):261-74. DOI: 10.1002/nau.10066. View

15.

Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U . The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002; 21(2):167-78. DOI: 10.1002/nau.10052. View

16.

Haylen B, Chiu T, Avery D, Zhou J, Law M . Improving the clinical prediction of detrusor overactivity by utilizing additional symptoms and signs to overactive bladder symptoms alone. Int Urogynecol J. 2014; 25(8):1115-20. DOI: 10.1007/s00192-014-2362-5. View

17.

Jeong S, Lee M, Song S, Kim H, Choo M, Cho S . Prevalence and urodynamic characteristics of detrusor overactivity with impaired contractility in the community-dwelling elderly with non-neurogenic lower urinary tract symptoms: Is it from a single or two independent bladder dysfunctions?. Investig Clin Urol. 2021; 62(4):477-484. PMC: 8246009. DOI: 10.4111/icu.20200471. View

18.

Hashim H, Abrams P . Is the bladder a reliable witness for predicting detrusor overactivity?. J Urol. 2006; 175(1):191-4. DOI: 10.1016/S0022-5347(05)00067-4. View

19.

Matharu G, Donaldson M, McGrother C, Matthews R . Relationship between urinary symptoms reported in a postal questionnaire and urodynamic diagnosis. Neurourol Urodyn. 2004; 24(2):100-5. DOI: 10.1002/nau.20093. View

20.

Seval M, Cetinkaya S, Kalafat E, Dokmeci F . A prediction model for detrusor overactivity at ambulatory urodynamics in women with urinary incontinence. Eur J Obstet Gynecol Reprod Biol. 2020; 251:156-161. DOI: 10.1016/j.ejogrb.2020.05.035. View