Urodynamic diagnoses and quality of life in women presenting for evaluation of urinary incontinence

Background: Several population-based and clinical studies report that stress incontinence has less impact on quality of life (QoL) than urge incontinence and overactive bladder. Aims: This research aimed to determine if this relationship held true for urodynamic diagnoses. Methods: Quality of life was evaluated by the King’s Health Questionnaire prior to urodynamic testing in 326 women presenting with lower urinary tract symptoms and who completed a 48-h frequency volume chart. Urodynamic results were categorised as ‘normal’, ‘sensory abnormalities only’, ‘idiopathic detrusor overactivity (IDO) only’, ‘urodynamic stress incontinence (USI) only’ or ‘mixed (IDO and USI)’. QoL data were compared using these diagnostic categories. Results: Women in mixed, USI and IDO categories had significantly worse QoL scores in the domain Severity Measures than women in sensory or normal categories (P < 0.0001). Incontinence Impact was significantly worse in mixed and IDO categories compared with normal (P = 0.006) but not compared with women with USI. Sleep/Energy scores were significantly worse for women in mixed and IDO categories compared with women with USI (P = 0.003). Significant differences between urodynamic categories were also observed in the domains Role Limitations, Social Limitations and General Health. Conclusions: Mixed incontinence had the greatest adverse effect on QoL; however, any abnormal urodynamic diagnosis was associated with a significantly adverse effect. Although a normal urodynamic result was associated with less impact on QoL than an abnormal result, there was still an effect present. The optimal management (eg conservative vs surgical management) of women with a normal urodynamic result is yet to be established.Paul Dugga