슬라이드 1

Female Voiding Dysfunction: What are We Trying to Treat? Recent Advance in Management

권동득 Department of urology, Chonnam National University Hwasun Hospital

What’s the female voiding dysfuction? 

Female voiding dysfunction is complex in nature poorly understood, lacks standard definition no consensus on diagnostic criteria difficult to treat

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Majority of women – neurologically intact but cause is idiopathic

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It’s common & affect QoL but paucity of literature on its management CHONNAM

NATIONAL

UNIVERSITY

HOSPITAL

Female voiding dysfunction 

No agreed classification specific to female voiding dysfunction

ICS definition of voiding dysfunction “A complex of symptoms represented by abnormalities of sensation related to voiding” Focusing on bladder and urethral activity during voding Bladder: detrusor underactivity, acontractile bladder Urethra: bladder outlet obstruction, intermittent involuntary contraction of periurethral muscle during voiding, detrusor sphinter dyssynergia, non-relaxing urethral sphincter obstruction Abrams et al. Neurourol Urodyn 2002;21:119-167

CHONNAM

NATIONAL

UNIVERSITY

HOSPITAL

Prevalence of LUTS and associated bother in women Coyne KS et al. BJUI 2009;104:352-360

CHONNAM

NATIONAL

UNIVERSITY

HOSPITAL

Overlap of storage, voiding and postmicturition symptoms  

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EpiLUTS survey 15861 women 75% women reported at least one LUTS

Sexton CC et al. BJUI 2009;103:3:S12-S23

CHONNAM

NATIONAL

UNIVERSITY

HOSPITAL

Overlap of storage, voiding and postmicturition symptoms Sexton CC et al. BJUI 2009;103:3:S12-S23

CHONNAM

NATIONAL

UNIVERSITY

HOSPITAL

Classification of voiding difficulties & retention

Monga AK. Textbook of urogynecology 2001, pp. 855-863.

Condition

Symptoms

Urodynamic data

Asymptomatic VD

Frequency UTI

Reduced flow, elevateated, normal or reduced voiding pressure with or without residual urine

Symptomatic VD

Reduced stream, incomplete emptying, straining, frequency, UTI

Peak flow