The effect of urethral dilatation on pressure flow studies in women with voiding dysfunction and overactive bladder.

Introduction and hypothesis: The aim of this study was to assess whether urethral dilatation (UD) leads to changes in pressure flow parameters in women with voiding dysfunction (VD) and whether this correlates with improvement in overactive bladder symptoms (OAB).

Methods: Forty three women with drug-resistant OAB and VD underwent cystoscopy and UD. Pressure flow studies were undertaken at 6 weeks with further follow-up at 6 months. Any significant changes in pressure flow parameters after UD were evaluated.

Results: Thirty three percent of the participants reported subjective improvement. This was maintained at 6 months in 19%. Improvement in OAB was associated with an increase in maximum flow rate centile (p = 0.02) and a decrease in detrusor pressure at maximum flow (p = 0.03). Thirteen percent developed urodynamic stress incontinence.

Conclusions: Thirty three percent of women with drug-resistant OAB have a short-term improvement following UD. Improvement is associated with an increased maximum flow rate centile and a decreased detrusor pressure at maximum flow. The long-term improvement rate is poor.