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

Vol. 45 (4): 798-806, July – August, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0556


ORIGINAL ARTICLE

Juan Pablo Valdevenito 1, 2, José Flores 1, Rodrigo Guzman Rojas 2, Valentin Manriquez 2, Leandro Arribillaga 3, Juan de Benito 4
1 Department of Urology, Urodynamics Unit, Hospital Clínico Universidad de Chile, Santiago, Chile; 2 Department of Obstetrics and Gynecology, Female Pelvic Floor Unit, Hospital Clínico Universidad de Chile, Santiago, Chile; 3 Centro Urológico Profesor Bengió, Córdoba, Argentina; 4 Department of Urology, Instituto Modelo de Cardiología SRL, Córdoba, Argentina

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 diffi culty 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: Urination; Women; Retrospective Studies

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