MP71-14 VIDEOURODYNAMIC ANALYSIS OF MEN WITH LOWER URINARY TRACT DYSFUNCTION AND LARGE POSTVOID RESIDUAL URINE VOLUME

Abstract

INTRODUCTION AND OBJECTIVES: Lower urinary tract symptoms (LUTS) may result from bladder dysfunction and bladder outlet dysfunction. The diagnosis of vesicourethral dysfunction based on LUTS has been considered inaccurate. This study analyzed the bladder and bladder outlet dysfunction in men with LUTS and large Postvoid residual volume (PVR). METHODS: Male patients aged > 45 years with bothersome LUTS were consecutively enrolled. All patients underwent prostatic ultrasound and video-urodynamic studies to evaluate the causes of their LUTS. Patients were divided into voiding dysfunction and bladder dysfunction groups. Patients with bladder dysfunction were further divided into subgroups of hypersensitive bladder, detrusor overactivity (DO), DO with inadequate contractility (DHIC), and detrusor underactivity (DU). Patients with voiding dysfunction were divided into benign prostatic obstruction (BPO), bladder neck dysfunction (BND), and poor relaxation of external sphincter (PRES) subgroups. The video-urodynamic findings were compared among patients with different subgroups of voiding dysfunction and having PVR > 250 mL. RESULTS: A total of 2831 patients were analyzed. Bladder outlet obstruction (BOO) was noted in 1356 patients (47.9%), bladder dysfunction in 861 (30.5%), and PRES in 485 (17.1%) (Table 1). In 299 patients with PVR > 250 mL, DU was noted in 108 (36.1%), DHIC in 44 (14.7%), BOO in 112 (37.5%) and PRES in 31 (10.4%) (Table 2). The urodynamic parameters showed higher voiding pressure and smaller bladder sensation capacity in BOO subgroup compared with bladder dysfunction and PRES groups. CONCLUSIONS: This study revealed in men with LUTS and PVR > 250 mL, BOO only comprises 37.5%. Most of the patients had bladder dysfunction (DU or DHIC) or external sphincter dysfunction.