CORRESPONDENCE BETWEEN CLINICAL AND URODYNAMICS DIAGNOSIS: A REPORT FROM THE ITALIAN NATIONAL BIG DATA ON URODYNAMICS

Mancini V1, Gubbiotti M2, Balzarro M3, Carone R4, Finazzi Agrò E5, Giammò A4, Lamartina M6, Li Marzi V7, Antonelli A3, Musco S8, Rubilotta E3, Italian Big Data Group 09

Research Type

Clinical

Abstract Category

Urodynamics

Abstract 116
Urodynamics
Scientific Podium Short Oral Session 11
Thursday 24th October 2024
10:37 - 10:45
Hall N102
Urodynamics Techniques Urodynamics Equipment Bladder Outlet Obstruction Detrusor Overactivity Detrusor Hypocontractility
1. Urinary Incontinence Center, Urology and Renal Transplantation Unit, Policlinico di Foggia Hospital and University of Foggia, Foggia, Italy, 2. Ospedale La Gruccia, Dept. of Urology, Pelvic Unit, Montevarchi, Italy, 3. A.O.U.I. Verona, Dept. of Urology, Verona, Italy, 4. AOU Città della Salute e della Scienza, Dept. of Neuro-Urology, Turin, Italy, 5. University of Rome Tor Vergata, Urology Unit, Rome, Italy., 6. Candela Clinic, Urology Unit, Palermo, Italy, 7. University of Florence, Dept of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Florence, Italy, 8. Careggi University Hospital, Neuro-Urology Department, Florence, Italy, 9. 0
Presenter
Links

Abstract

Hypothesis / aims of study
To assess the use relationship between clinical and urodynamics (UD) diagnosis.
Study design, materials and methods
This was a national multicenter study on correspondence between clinical indications and UD results in Italy in the pre-Covid era 2018-19. Additional UD diagnoses were also recorded. This period has been chosen to have a real UD management scenario, because access to hospitals and UD offices has been reduced in the last 2 years due to the Covid-Sars limitations. Urological and gynecological centers were involved. Data on men and women were retrospectively collected between January and December 2022. Indications to UD and related UD diagnosis were evaluated to investigate the rate of correspondence. In females main indications recorded were: urinary incontinence (stress, urtgency, mixed), voiding dysfunction. Pelvic organ prolapse was assessed to investigate the UD results in this group of women. In men, bladder outlet obstruction (BOO), urinary retention (UR), iatrogenic urinary incontinence (UI) in 81%, overactive bladder syndrome (OAB), voiding dysfunctions (VD) were recorded as main indications.
Results
Centers involed were 13: 11 urological, 2 gynecological. Data were collected on 2358 patients, 1329 (56.4%) women with median age 62 y.o and 1029 men (43.6%) with median age 68 y.o.. The relationship between the main females indications and UD outcomes, with addional UD diagnoses, are reporte in table 1. In males, correspondences were as follows: bladder outlet obstruction (BOO) in 79.1%, urinary retention (UR) in 81.9%, iatrogenic urinary incontinence (UI) in 81%, overactive bladder syndrome (OAB) in 81.7%, voiding dysfunctions (VD) in 86.9%, concomitant BOO and OAB in 87.2%.
Interpretation of results
The correlation between clinical indications and UD outcomes was high in males, so outpatient evaluation was highly reliable. Correspondence between BOO clinical and UD diagnosis was great, and, interestingly, also the association BOO/OAB was highly detected at UD. In females, the match rate was >50% in SUI and VD conditions only. The most misleading clinical diagnoses were those related to urgency (UUI and MUI); in the latter, UD demonstrated different diagnoses in many patients. The low correspondence between clinical urgency (UUI and MUI) and UD diagnosis may be related to an incorrect clinical diagnosis or to a most complicated patient’s condition misleading the clinical diagnosis, or to a limit in the UD diagnosis. However, this finding highlights the relevance of UD investigation in female UI to obtain a proper diagnosis and avoid further unnecessary treatment. Among women with SUI, approximately 10% had detrusor overactivity (DO) or voiding disorders. In patients with symptomatic POP, UD demonstrated that VD and DO were often associated, while DUA occurred only in a smaller proportion of women.
Concluding message
A high relationship between clinical indications and UD  results was found in men, while in females only in case of SUI and VD. UD was still usefull in helping to reach a correct diagnosis avoiding potential further unnecessary treatments.
Figure 1 Relationship between the main females indications and UD outcomes, with addional UD diagnoses.
Disclosures
Funding None Clinical Trial No Subjects Human Ethics Committee Internal Clinic Audit Helsinki Yes Informed Consent Yes
Citation

Continence 12S (2024) 101458
DOI: 10.1016/j.cont.2024.101458

13/11/2024 18:42:58