Can female voiding dysfunction be predicted using a questionnaire?

Objectives: To evaluate symptoms using the modified International Prostate Symptoms Score (wIPSS) questionnaire, and clinical factors that could indicate objective VD in women.

Methods: 1083 women who underwent urodynamic assessment were retrospectively analysed. The primary outcome was objective VD. Two definitions were utilised; VD1 defined VD as maximum flow rate <10^th centile on the Liverpool nomogram, while VD2 defined VD as Qmax ≤ 15ml/s and PVR ≥ 100ml. Associations of potential explanatory variables with VD were assessed by standard bivariate testing. Classification and Regression Tree (CART) analyses were conducted to assess the discriminatory power of explanatory variables for VD.

Results: The prevalence of objective VD depended on the definition used (VD1-30.9% vs. VD2-5.8%), as did the median wIPSS score (VD1-15, IQR 10-20 vs. VD2-12.5, IQR 10.3-22.8). Age, menopausal status, previous pelvic floor surgery, current degree of anterior/apical prolapse, a medical history of diabetes or neurological disease, the wIPSS score as well as the wIPSS with additional items were associated with VD. CART analysis revealed the questions regarding force of stream (FOS) and hesitancy were the strongest predictors for VD.

Conclusion: Rates of objective VD depend on the definition used. VD was associated with the overall wIPSS score, and the additional questions of hesitancy and FOS which proved to be the most powerful predictors. This modified wIPSS may be a useful tool in screening for the absence of objective VD.

Brief summary: Can we use a non-invasive screening tool to evaluate for female voiding dysfunction?