Urinary Incontinence Clinical Trial
Official title:
A Follow-net Investigation of a Randomised Study of Cystoscopy and Urethral Dilatation Versus Cystoscopy Alone in Women With Overactive Bladder Syndrome and Impaired Voiding
Urinary incontinences is a highly prevalent and distressing condition which has a
significant impact on health related quality of life in millions of women worldwide. Of all
women with incontinence, 90% will have overactive bladder symptoms (OAB), and 50% will have
detrusor overactivity (DO) on cystometry. The overactive bladder syndrome is defined by the
International Continence society as "Urinary urgency, with or without urge incontinence,
usually with frequency and nocturia if there is a no infection or proven pathology" (Abrams
et al 2002)
Initial management of OAB and DO consists of conservative measures such as altering fluid
intake, bladder retraining and drug therapy. The next step consists of interventions such as
cystoscopy and urethral dilatation, on the basis that it will allow intrinsic bladder
problems such as interstitial cystitis to excluded, excluded, and may confer a symptomatic
benefit.
The original study showed no benefit of urethral dilatation versus no dilatation at 6 months
follow up (Duckett 2007). The investigators do not know the natural history of patients with
voiding dysfunction. Therefore reviewing their symptoms will give a better idea of what
happens to these patients symptoms over time.
Urinary incontinences is a highly prevalent and distressing condition which has a
significant impact on health related quality of life in millions of women worldwide. Of all
women with incontinence, 90% will have overactive bladder symptoms (OAB), and 50% will have
detrusor overactivity (DO) on cystometry. The overactive bladder syndrome is defined by the
International Continence society as "Urinary urgency, with or without urge incontinence,
usually with frequency and nocturia if there is a no infection or proven pathology" (Abrams
et al 2002)
Initial management of OAB and DO consists of conservative measures such as altering fluid
intake, bladder retraining and drug therapy. The next step consists of interventions such as
cystoscopy and urethral dilatation, on the basis that it will allow intrinsic bladder
problems such as interstitial cystitis to excluded, excluded, and may confer a symptomatic
benefit.
Cystoscopy and urethral dilatation have long been advocated as empirical treatments for
women with lower urinary tract symptoms (LUTS). A review of the literature reveals a marked
lack of evidence regarding the survey of practice amongst UK urologists found that 61% had
performed urethral dilatation 7 or more times during the year in which the survey was
conducted, although 55% believed that less than half of the patients experience long term
improvement (Masarani and Willis, 2006)
The original study showed no benefit of urethral dilatation versus no dilatation at 6 months
follow up (Duckett 2007). The investigators do not know the natural history of patients with
voiding dysfunction. Therefore reviewing their symptoms will give a better idea of what
happens to these patients symptoms over time. The aim of the study is to identify any long
term benefit from urethral dilatation over cystoscopy alone.
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Observational Model: Cohort, Time Perspective: Prospective
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