Prevalence and predictors of detrusor underactivity and bladder outlet obstruction in women with lower urinary tract symptoms

This study aims to present age-stratified prevalence of women with lower urinary tract symptoms (LUTS) but without cystocele and predict detrusor underactivity (DU) or bladder outlet obstruction (BOO). Between 2005 and 2020, we reviewed women who visited the medical center with LUTS but without cystocele. Positive voiding dysfunction (VD) symptoms were defined as any one or more of the positive descriptions of weak urinary stream, intermittency, strain to urination, and sensation of not emptying. A total of 1,886 women were included in this study. 189 (10.0%) women were diagnosed with DU, and 77 (4.1%) women had BOO. Multivariate logistic regression analysis found that voided volume and VD symptoms were independent predictors for BOO. ROC curve analyses could predict BOO by voided volume <= 220 mL derived from uroflowmetry and the presence of VD symptoms with an area under a curve of 0.83. Age and voided volume could predict DU with an area under a curve of 0.82. We found a higher percentage of BOO in women with positive VD symptoms. A non-invasive uroflowmetry with voided volume (<= 220 mL) and the presence of VD symptoms can predict BOO. DU could be predicted by age and voided volume.