URODYNAMIC VARIABLES CANNOT BE USED TO CLASSIFY THE SEVERITY OF DETRUSOR INSTABILITY

Objective To explore the relationship between subjective severity of s ymptoms of detrusor instability (DI) on presentation, outcome after tr eatment for DI and initial diagnostic urodynamic variables, with the a im of identifying a urodynamic variable which might, by predicting a f avourable outcome from treatment, classify the severity of DI. Patient s and methods Women with a urodynamically proven diagnosis of DI were recruited prospectively for the study. Data on disease symptoms and va riables from their diagnostic cystometrogram were collected. All women were then treated and their outcome at 6 weeks after treatment compar ed with the initial urodynamic variables. Data on severity of symptoms were compared with initial urodynamic variables to explore any differ ences in these variables attributable to symptom severity. Results Of 300 women studied (mean age 54 years, SD 16), 290 were treated with ox ybutynin and bladder retraining. At 6 weeks, 82 women had their treatm ent outcome classified as worse/no change; 218 women had improved. Whe n good or poor outcome was compared with the urodynamic results, there was no significant difference between the groups. Likewise, the sever ity of symptoms did not; relate to the values of urodynamic variables. Conclusions There was no statistically significant relationship betwe en reported severity of symptoms and urodynamic variables, and no rela tionship between the urodynamic variables used and response to treatme nt. Therefore, using these values it is not possible to predict a favo urable outcome from treatment or to use them to classify disease sever ity.