MP68-09 URODYNAMICS IN UNDERACTIVE BLADDER: ABNORMAL VOLUME MANAGEMENT VS. DETRUSOR DEFICIENCY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Basic Research & Pathophysiology II1 Apr 2016MP68-09 URODYNAMICS IN UNDERACTIVE BLADDER: ABNORMAL VOLUME MANAGEMENT VS. DETRUSOR DEFICIENCY Gerard Pregenzer, Jason K Frankel, and Phillip Smith Gerard PregenzerGerard Pregenzer More articles by this author , Jason K FrankelJason K Frankel More articles by this author , and Phillip SmithPhillip Smith More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1346AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Underactive bladder (UAB) is an emerging concept proposed to describe a symptom complex of perceived difficulties with bladder emptying. Previous studies have shown it to not strongly correlate with detrusor underactivity (DU) or diminished contractility (DC). We reviewed urodynamic records of patients with UAB (voiding hesitancy, abnormal stream, or incomplete emptying sensations) in an initial attempt to identify pathophysiologic groupings. METHODS 501 urodynamic records were reviewed, of which 414 were of non-neurogenic patients who attempted to void. Records were sorted by UAB +/-, urodynamic observations, Watts Factor (WF), voiding efficiency (VE) and postvoid residual volume (PVR). Associations were sought using contingency tables and comparative statistics. RESULTS 125 patients reported symptoms characterizing UAB. Out of this group, only 42 were found to have DU, making the positive predictive value (PPV) of UAB for DU 33.6%. By contrast, 46 patients with UAB were found to have bladder outlet obstruction (BOO), 31 dysfunctional voiding (DV), 10 stress urinary incontinence (SUI) and 4 bladder neck dyssynergia (BND). No significant association between UAB and DC was found; this was true whether using the 25th percentile or one standard deviation below the mean for WF. No difference in VE was noted between the UAB and no-UAB groups. Mean PVR, however, was significantly elevated in UAB at 253 ml versus 130 ml in no-UAB. CONCLUSIONS UAB is associated with a variety of urodynamic observations, and is not predictive of a weak bladder or detrusor underactivity. It is associated with elevated PVR yet a similar VE as non-UAB symptoms, indicating greater bladder volumes at voiding initiation. UAB therefore may be an indicator of abnormally high operational bladder volumes rather than an inherent voiding deficiency. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e892 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Gerard Pregenzer More articles by this author Jason K Frankel More articles by this author Phillip Smith More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...