UTILITY OF BLADDER DIARIESCONTAINING FREQUENCY VOLUME CHARTS (FCV)
A. L. O'BOYLE1, Z. M.HIRSCH 2, L. J. POLICASTRO 3, J. G. BLAIVAS 4;
1Urology, Walter Reed Bethesda, BETHESDA, MD, 2Inst.for Bladder and Prostate Res., New York, NY, 3SUNYDownstate Med. Sch., Brooklyn, NY, 4Urology, SUNYDownstate Med. Sch., Brooklyn, NY.
Introduction: The frequencyvolume chart (FVC), measuring the time and volume of eachmicturition, is a standard tool used in lower urinary tract symptom(LUTS) research. In clinical practice however, the FVC is oftenomitted and treatment begun based on patient subjective complaints.Storage and voiding abnormalities such as polyuria (P), oliguria (O),nocturnal polyuria (NP), and small/large bladder capacity (SBC, LBC)can only be diagnosed by a FVC.
Objective: The primaryobjective of this study was to estimate the prevalence of storage andvoiding abnormalities in a population of women presenting with LUTSbased on the FVC. Secondarily we aimed to compare maximum voidedvolumes (MVV) from 24-hour bladder diaries (24HBD) to uroflow-voidedvolumes (UVV) in order to determine the accuracy of using UVV inplace of MVV data obtained from the FVC.
Methods: This is aretrospective multicenter observational study of consecutive womenpresenting for the evaluation of lower urinary tract symptoms (LUTS).Inclusion criteria were women who had completed a 24h bladder diary(24HBD) or FVC using a web-based interface or smartphone application.The following data was recorded for each patient: MVV, 24 hour voidedvolume (24HV), and nocturnal polyuria index (NPi). A contemporaneousUVV was collected for each patient after they were instructed todrink until their bladder felt full. Corresponding diagnoses werederived as follows: O (24HV < 1L); normal (24HV=1-2.5 L); P (24HV> 2.5 L); NP (NPi > .33); SBC (MVV <150 mL); LBC (MVV >350 mL). Spearman correlation was calculated between UVV andMVV.
Results: A total of 240 women mean age 52 years (18-75years) were available for analysis. Prevalence of FVC-derivedconditions in this population is shown in Table 1. Of 240 womenevaluated, 52 had uroflow data available. Analysis of the correlationbetween MVV and UVV are shown in Table 2. The MVV and UVV differed byan average of 166 mL, with the UVV being an average of 106 mL lessthan the MVV, Figure 1.
Conclusions: P, O, NP, LBC and SBCare not uncommon in patients with LUTS; around a third of patientshad either O or P and 18% had NP. Although this data may not bedirectly transferable to the general population, the concept issound, i.e. that without measurement of voided volumes during a FVC,it is difficult or impossible to diagnose these conditions.Furthermore, there is only a weak correlation between UVVmeasurements and MVV obtained by FVC; neither value, by itself is areliable measure of MVV, so it is most prudent to obtain bothmeasures - the largest recorded volume is the MVV.