Joseph Abarbanel1, Esther-Lee Marcus. 1. Department of Urology, Rabin Medical Center (Hasharon Hospital), Petach-Tikva, Israel. abar1@zahav.net.il
Abstract
OBJECTIVES: To determine the prevalence of impaired detrusor contractility (IDC) with and without detrusor hyperactivity (DH) among community-dwelling elderly with lower urinary tract symptoms and to identify which patients are at a greater risk of having a hypocontractile detrusor. METHODS: We performed a retrospective chart review of all patients 70 years old or older with storage and/or voiding lower urinary tract symptoms who had undergone urodynamic pressure-flow studies in a urodynamic referral center during a 2-year period. RESULTS: During the study period, 181 patients (82 men [45%] and 99 women [55%]), aged 70 years or older (mean age 75.7 +/- 4.8), underwent urodynamic studies. IDC was detected in 39 (48%) of the 82 men and in 12 (12%) of the 99 women. Two thirds of the men and one half of the women with IDC also had involuntary detrusor contractions during the filling phase and/or low bladder compliance. The prevalence of IDC/DH-IDC was significantly greater in those with a history of urinary retention and an indwelling urethral catheter. CONCLUSIONS: Detrusor-impaired contractility is an important pathophysiologic mechanism in older patients with lower urinary tract symptoms, especially in men. Establishing the diagnosis by urodynamic pressure-flow studies is crucial for determining treatment--potentially harmful to this vulnerable population--from objective parameters rather than by empirical decisions.
OBJECTIVES: To determine the prevalence of impaired detrusor contractility (IDC) with and without detrusor hyperactivity (DH) among community-dwelling elderly with lower urinary tract symptoms and to identify which patients are at a greater risk of having a hypocontractile detrusor. METHODS: We performed a retrospective chart review of all patients 70 years old or older with storage and/or voiding lower urinary tract symptoms who had undergone urodynamic pressure-flow studies in a urodynamic referral center during a 2-year period. RESULTS: During the study period, 181 patients (82 men [45%] and 99 women [55%]), aged 70 years or older (mean age 75.7 +/- 4.8), underwent urodynamic studies. IDC was detected in 39 (48%) of the 82 men and in 12 (12%) of the 99 women. Two thirds of the men and one half of the women with IDC also had involuntary detrusor contractions during the filling phase and/or low bladder compliance. The prevalence of IDC/DH-IDC was significantly greater in those with a history of urinary retention and an indwelling urethral catheter. CONCLUSIONS: Detrusor-impaired contractility is an important pathophysiologic mechanism in older patients with lower urinary tract symptoms, especially in men. Establishing the diagnosis by urodynamic pressure-flow studies is crucial for determining treatment--potentially harmful to this vulnerable population--from objective parameters rather than by empirical decisions.
Authors: Joshua A Cohn; Shenghua Ni; Melissa R Kaufman; Amy J Graves; David F Penson; Roger R Dmochowski; W Stuart Reynolds Journal: Neurourol Urodyn Date: 2017-03-07 Impact factor: 2.696
Authors: Tomas L Griebling; Catherine E DuBeau; George Kuchel; Mary H Wilde; Michelle Lajiness; Hikaru Tomoe; Ananias Diokno; Andrew Vereecke; Michael B Chancellor Journal: Int Urol Nephrol Date: 2014-09-20 Impact factor: 2.370
Authors: Pradeep Tyagi; Phillip P Smith; George A Kuchel; William C de Groat; Lori A Birder; Christopher J Chermansky; Rosalyn M Adam; Vincent Tse; Michael B Chancellor; Naoki Yoshimura Journal: Int Urol Nephrol Date: 2014-09-20 Impact factor: 2.370