Voiding symptoms obtained by open versus directed anamnesis as predictors of voiding dysfunction in women

Int Braz J Urol. 2019 Jul-Aug;45(4):798-806. doi: 10.1590/S1677-5538.IBJU.2018.0556.

Abstract

Objectives: To determine the differences between voiding symptoms obtained by open anamnesis (VS-Open) versus voiding symptoms obtained by directed anamnesis (VSDirected) to predict voiding dysfunction in women.

Materials and methods: Retrospective study of women with prior anti-incontinence surgery evaluated during 5 years. In a standardized clinical history taking, each patient was asked to answer question number fi ve of the UDI-6 questionnaire ("Do you experience any difficulty emptying your bladder?"). If the answer was positive, the following voiding symptoms spontaneously described by the patient were documented: slow urine stream, straining to void, intermittent stream and feeling of incomplete bladder emptying, which were considered VS-Open. If the answer to this question was negative or if the patient had not reported the four voiding symptoms, she was asked in a directed manner about the presence of each of them, which were considered VS-Directed. Voiding dysfunction was considered the presence of a maximum fl ow ≤ 12 mL/s and/ or a postvoid residual > 100 mL.

Results: Ninety-one women are analyzed. Eighteen patients presented voiding dysfunction (19.8%), There was a statistical association between voiding dysfunction and the presence of any VS-Open (p = 0.037) and straining to void obtained by open anamnesis (p = 0.013). Sensitivity, specificity, PPV, NPV, positive likelihood ratio and negative likelihood ratio, respectively, were 44.4% and 27.8%, 80.8% and 94.5%, 36.3% and 55.6%, 85.5% and 84.1%, 2.324 and 5.129, and 0.686 and 0.764. There was no statistical association between voiding dysfunction and VS-Directed.

Conclusions: VS-Open may predict better voiding dysfunction than VS-Directed in women.

Keywords: Retrospective Studies; Urination; Women.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Medical History Taking / methods*
  • Middle Aged
  • Predictive Value of Tests
  • Reference Values
  • Reproducibility of Results
  • Retrospective Studies
  • Surveys and Questionnaires
  • Urinary Bladder / physiopathology
  • Urinary Incontinence / surgery
  • Urination Disorders / diagnosis*
  • Urination Disorders / physiopathology*
  • Urodynamics