Predictability of urodynamic findings based on the Urogenital Distress Inventory-6 Questionnaire

Objectives. The Urogenital Distress Inventory (UDI-6) is a validated 6-item questionnaire that assesses lower urinary tract symptoms, including incont inence, in women. Similar indexes developed in men to evaluate symptoms of benign prostatic hyperplasia have failed to show a relationship with urodyn amic (UD) parameters indicating bladder outlet obstruction (800). In this s tudy, we sought to determine whether UDI-6 responses could predict informat ion obtained during UD evaluations. Methods. All women referred to our clinic with lower urinary tract complain ts who completed a UDI-6 questionnaire and subsequently underwent UD evalua tion were included (n = 128). UD findings used for analysis included Valsal va leak point pressure (VLPP), maximum flow rate (Qmax), and detrusor press ure at Qmax (PdetQmax). BOO was defined as Qmax of 15 mL/s or less and PdeT Qmax of greater than 20 cm H2O; detrusor overactivity (DO) was defined as a ny rise in detrusor pressure associated with urge during filling. Results. The most common chief complaints were incontinence (mixed, 26.6%; stress, 20.3%; and urge, 13.3%), urgency/frequency(14.1%), and symptomatic prolapse (10.1%). There was a moderate correlation between a positive respo nse to question 5 (stress urinary incontinence [SUI]) and leakage with stra in or cough during UD evaluation (correlation coefficient = 0.51). In fact, most patients answering that SUI was moderately or greatly bothersome were found to have stress-induced leakage during the UD evaluation (82%), which differed significantly from those who reported no bother (Fisher's exact t est, P = 0.0006). Severity of leakage assessed by VLPP, however, did not co rrelate with the severity assessed by any question. With regard to 800 in w omen, most patients who answered that incomplete emptying was their most bo thersome symptom had BOO (61%), and most women with a different main compla int were unobstructed (73%, P < 0.002). Finally, 30 of 56 women who answere d that leakage related to urgency was moderately or greatly bothersome were found to have DO, which was significantly different than the incidence of DO in women who did not report this complaint (correlation coefficient = 0. 38, P < 0.001). Conclusions. Unlike similar indexes used to assess lower urinary tract symp toms in men, specific items from the UDI-6 may provide predictive informati on regarding UD findings in women, particularly with regard to SUI, BOG, an d DO. However, if VLPP is considered vital to planning treatment, UD studie s will still be required, since no question could estimate the severity of incontinence as determined by serial VLPP measurement. O 1999, Elsevier Sci ence Inc.