TITLE:
The Additional Value of Cystoscopy with Urodynamic Study in the Assessment of Patients with Urinary Incontinence
AUTHORS:
Diar Hameed Bajalan, Sarwar Noori Mahmood, Ismaeel Hama Ameen, Zhino Noori Hussain
KEYWORDS:
Urodynamic Study, Diagnostic Cystoscopy, Incontinence
JOURNAL NAME:
Open Journal of Urology,
Vol.6 No.7,
July
13,
2016
ABSTRACT: Background: Urinary incontinence (UI) is
generally defined as the involuntary loss of urine from the bladder through the
urethral meatus. Filling cystometry is the method by which the pressure/ volume
relationship of the bladder is measured during bladder filling. Purpose: To
determine the value of diagnostic cystoscopy in addition to Urodynamic study
(UDS) in patients with primary urinary incontinence. Material and Methods: 200
patients with primary incontinence studied prospectively from January 2013 to June
2014. Their age ranges from (14 - 93 years), 86.5% were female, and 13.5% of
them were male. In addition to physical, neurological examination and
bio-chemical investigations, urine analysis and urine culture with Ultra-sound
and Post void residual volume (PVRV), all patients underwent diagnosticflexible
cystoscopy under local anesthesia, and urodynamic study. Result: 43.5% of
patients age were between (34 - 53 years), (39%) between (54 - 73 years), (9%)
between (14 - 33 years) and (8.5%) were between (74 - 93 years). Atonic bladder
on UDS were (40.5%), Detrusor over activity (29%), patients with normal UDS
were (22%) and patients that had DSD (Detrusor Sphincter Dyssynergia) were
(8.5%). Eighty-four cases (42%) were found to have normal cystoscopy, those
with grade-I-II bladder wall trabeculations were (49%) and patients with
grade-III were (8.5%). Sixty-one patients (30.5%) with normal diagnostic
cystoscopy have abnormal UDS (Atonic bladder, over-active bladder and DSD)
while twenty-one (10.5%) patients with normal UDS had bladder wall
trabeculations (grade-I-III) on diagnostic cystoscopy. Conclusion: Diagnostic
cystoscopy in addition to urodynamic study will put in further knowledge in the
assessment of patients with urinary incontinence. To some extent, it can
predict the diagnosis.