MP74-18 DETRUSOR VOIDING CONTRACTION VELOCITY IS RELEVANT TO PATIENTS WITHOUT BLADDER OUTFLOW OBSTRUCTION

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP74-18 DETRUSOR VOIDING CONTRACTION VELOCITY IS RELEVANT TO PATIENTS WITHOUT BLADDER OUTFLOW OBSTRUCTION Peter F. W. M. Rosier Peter F. W. M. RosierPeter F. W. M. Rosier More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003348.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder outflow obstruction (BOO) is prevalent in male patients >45 y with LUTS but much less in women. Detrusor voiding contraction underactivity (DVC-DU) is (equally?) prevalent in in both sex. BOO affects DVC through 'compensation'; muscle training, to gain force, which is represented in DVC-detrusor- pressure. DVC-muscle shortening velocity (muscle function Hill equation) is less known/studied and is potentially relevant as an element of DVC-DU. We analysed DVC parameters including contraction velocity in a large cohort of adult men and women without BOO. METHODS: Patients without relevant neurological or anatomical abnormalities, voiding (pressure flow studies PFS) >100 mL and <800 mL with PVR <500 mL, representative, after ICS (quality) standard UDS, for all usual/possible indications, with 7F double lumen water fill cystometry, were included. All known DVC parameters were analysed and DVC-velocity is calculated: (bladder circumference (based on mL) at begin voiding minus circumference at end) / voiding time (tQ>0). All patients had BOO<3 linPURR (ICS- noOBS). 2488 patients were 63.5 y (sd 16.8) men (n1511) 66.3 y (15.1) and women (n977) 59.2 y (18.3). They voided 359 mL with PVR 47 mL; void% 89.3. RESULTS: PFS-voided volumes were not different Void% was slightly lower in men (88.6 vs 90.4). Men's Qmax 12.5 mL/s; pdetQmax 43.3 cm H2O; BOOI 18.1; and Wmax 12.3 W/m2 differed signific. from women Qmax 19.9 mL/s; pdetQmax 25.7 cm H2O; BOOI -14.1; and Wmax 13.0 W/m2. DVC-velocity was 0.37 cm/s in men vs 0.56 cm/s (p.000). 58.4% of men had void%100 62.2% of women. The Figure 1 demonstrates the relevance of DVC-velocity to predict incomplete voiding, in absence of BOO. CONCLUSIONS: Men with LUTS have somewhat higher outflow resistance than women even when they are all within the no BOO -category. Anatomical differences likely the cause. Only a small percentage of all female patients has outflow obstruction (>grade 2) and diagnosing DVC especially in cohorts of female patients (but also in men without BOO) requires a parameter that includes detrusor contraction velocity. Most of the currently available parameters to represent the contraction force or -strength of the DVC include detrusor pressure -with a certain weight- in a mathematical product. If there is no or low grade outflow resistance however, not contraction power (≈pressure), but contraction speed (velocity or (flow)rate) is more important. This is now supported by this analysis showing that, in patients without BOO (<grade3) DVC-velocity, has the highest predictive value to predict incomplete micturition. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1077 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter F. W. M. Rosier More articles by this author Expand All Advertisement PDF downloadLoading ...