Is cystourethroscopy alone enough to diagnose bladder outlet obstruction in post- menopausal female patients? A comparative analysis with urodynamic and radiological evaluation

DOI: 10.21276/sjams.2017.5.9.36 Abstract: The diagnosis and management of bladder outlet obstruction among postmenopausal patients is a complex process with various modalities available for its diagnosis. Cystourethroscopy is an important tool for the same and we intend to study if it is enough in the diagnosis of the presence and degree of bladder outlet obstruction in post-menopausal female patients with lower urinary tract symptoms. Postmenopausal female patients with voiding symptoms were subjected to urodynamic study, micturating cystourethrogram and cystourethroscopy to see if the findings of the cystourethroscopy correlated with the other two modalities of diagnosis and grading of bladder outlet obstruction.Fifty four patients were recruited in the study. The American Urological Association symptom scores and their grades of severity were obtained and compared with their urodynamic study, cystoscopy and micturating cystourethrography findings. There was positive correlation between the worsening symptom grades and increasing scores with respect to the higher grades of the urodynamic and cystoscopic findings and urethrography findings for bladder outlet obstruction. Also, the cystoscopy findings not only correlated well with the urodynamic findings but also, it was able to identify patients with severe bladder outlet obstruction earlier than urodynamic study. Cystourethroscopy is a significant tool in both the diagnosis of bladder outlet obstruction and its grading among postmenopausal females with voiding lower urinary tract symptoms and it may be alone enough for the same especially in situations where urodynamic study is difficult due to logistic reasons.