Is there a correlation between urodynamics findings and clinical outcomes in females with idiopathic overactive bladder syndrome (OAB).

Introduction: This study investigates the intricate relationship between urodynamic findings and clinical symptoms in females with overactive bladder (OAB).

Methods: A retrospective cohort study, conducted at a tertiary university hospital, included female patients with positive detrusor overactivity (DO) OAB between November 2020 and November 2023. Patient demographics, OAB symptoms, and responses to anticholinergic treatment were recorded. Different Urodynamic features were analyzed.

Results: A total of 92 female patients with positive detrusor overactivity (DO) and overactive bladder (OAB) were included. The median age was 49 years (IQR: 30.75-61.75). Among them, 16 (17.4%) were diabetic, 18 (19.6%) had hypertension, and 69 (75%) were regular coffee drinkers. Over half of the participants, 56 (60.9%), were overweight (BMI 25-29.9). The prevalence of key symptoms included frequency in 54 (58.7%), urgency in 73 (79.3%), urgency incontinence in 33 (35.9%), and nocturia in 44 (47.8%). Frequency of urination was more common among non-diabetic patients (41/54, 75.9%; p = 0.04), and urgency was significantly associated with non-smoking status (51/73, 69.9%; p = 0.025). Most patients (84, 91.3%) had phasic DO, with a median maximum detrusor pressure (Pdet DO) of 30 cmH₂O (IQR: 20.0-53.0) and a median cystometric capacity of 385.5 mL (IQR: 296.25-443.75). Frequency was significantly associated with higher maximum Pdet DO pressure (p = 0.049). In terms of treatment response, 81 patients (88.0%) demonstrated a good response to anticholinergic therapy. Non-responders had significantly higher maximum Pdet DO pressure (median 59.0 cmH₂O, IQR: 30.0-66.0) compared to responders (median 30.0 cmH₂O, IQR: 19.5-47.0; p = 0.013).

Conclusion: The amplitude of DO in female with idiopathic OAB is theoretically and clinically correlated to symptomatology and response to anticholinergic treatment.