The repeat use of a filling/voiding cystometrogram does not alter the urodynamic diagnosis in adults with idiopathic detrusor overactivity

Summary 

Objectives

The natural history of idiopathic detrusor overactivity (IDO) is poorly understood. The precise role of cystometry in the long-term management of IDO remains unclear. We hypothesized that repeat cystometry in adults with the OAB syndrome, in whom a urodynamic diagnosis of IDO had already been made, would not lead to a change in the urodynamic diagnosis.

Patients and methods

Departmental records were reviewed retrospectively and adult patients who had undergone cystometry more than once, and received a diagnosis of IDO on their initial CMG were included. Patients who had received a urodynamic diagnosis of neurogenic DO, BOO or urodynamic SUI were excluded as were patients who had undergone a reconstructive or bladder outlet procedure following their initial CMG. The urodynamic traces were re-evaluated to determine if the urodynamic diagnosis had changed.

Results

50 patients were identified and used in the analysis. The mean interval between first and last CMG was 55.9 months. The same qualitative urodynamic diagnosis was found in 48 out of 50 cases (p=1.19×10⁻⁴⁰ using Student's t-test).

Conclusions

The urodynamic findings of IDO persist in the long-term, and in the absence of a significant change in symptoms, such repeat urodynamics are unlikely to yield additional information, even at intervals of several years.

Keywords: Cystometry, Urodynamics, Detrusor overactivity