Is there a difference between women with or without detrusor overactivity complaining of symptoms of overactive bladder

Experts’ summary: The role of urodynamic diagnosis of detrusor overactivity (DO) in women with idiopathic overactive bladder (OAB) was the focus of the recent cross-sectional study by Giarenis and colleagues. To evaluate whether urodynamic study (UDS) is able to add some relevant information in these patients, the authors performed laboratory (and when it was necessary, ambulatory) UDS in 556 consecutive women with OAB symptoms. Of these patients, 43% presented urodynamically proven DO. Comparing this group with women with OAB symptoms but without DO, the authors found that DO could be considered as a more severe form of the OAB syndrome. Women with DO experienced a significantly higher number of urgency episodes and significantly higher maximum and mean urge ratings. Subjectively, DO was associated with a greater impact on quality of life. Therefore, this finding induced the authors to state that OAB in the presence of DO is a particularly severe form of OAB, with possibly a different pathophysiologic mechanism.