Urodynamics in the octogenarian female: is it worthwhile?

Introduction and hypothesis We hypothesized that urinary symptoms in elderly females correlate poorly with urodynamic diagnosis, which would impact on management. Methods Charts of 53 consecutive females over age 80 undergoing multichannel urodynamics according to the International Continence Society standards were retrospectively analyzed. Results Median age was 83 years. Urodynamic stress incontinence was the most common diagnosis, in 26/53 (49%). Detrusor overactivity was found in only 12 (29%) of 42 females presenting with pure storage symptoms, and reduced compliance was seen in eight (19%). Urodynamics resulted in complete change in patient management in 43% of cases and helped 52% of referring physicians in confirming provisional diagnosis prior to drug or surgical treatment. Conclusions In octogenarian females, there is poor correlation between storage symptoms and urodynamic diagnosis. Thus, urodynamics guides patient management and may avoid empirical prescribing associated with adverse effects in this clinically vulnerable population.