MP76-10 OBSTRUCTION DEPENDENT BLADDER CONTRACTILITY - RESULTS FROM A LARGE URODYNAMIC CROSS-SECTIONAL STUDY IN MEN WITH LOWER URINARY TRACT SYMPTOMS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-neurogenic Voiding Dysfunction1 Apr 2014MP76-10 OBSTRUCTION DEPENDENT BLADDER CONTRACTILITY - RESULTS FROM A LARGE URODYNAMIC CROSS-SECTIONAL STUDY IN MEN WITH LOWER URINARY TRACT SYMPTOMS Kevin Rademakers, Gommert van Koeveringe, and Matthias Oelke Kevin RademakersKevin Rademakers More articles by this author , Gommert van KoeveringeGommert van Koeveringe More articles by this author , and Matthias OelkeMatthias Oelke More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2403AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is much controversy defining detrusor contractility correctly. Earlier studies with experimental animals showed an increase in detrusor contraction power with increasing bladder outlet obstruction (BOO) in the compensated phase of the urinary bladder compared to non-obstructed bladders. Therefore, the aim of this study was to prove whether detrusor contraction power is increased in men with BOO and to what extend different BOO grades are associated with different levels of contractility. METHODS In this cross-sectional study we included male patients with uncomplicated LUTS but without signs of prostate cancer. All men received computer-urodynamic investigations as part of their baseline clinical assessment. The Schäfer-classification was used to determine BOO-grades (Schäfer 0-6) and detrusor contractility was quantified by calculation of the bladder contractility index (BCI) and maximum Watt factor (Wmax) obtained by pressure-flow analysis. Results were statistically analyzed in SPSS 18 using the Mann-Whitney U test. RESULTS The study population consisted of 786 men with a median age of 64 years (interquartile range [IQR] 59-70), IPSS 16 (IQR 11-21) and prostate volume of 37 cc (IQR 28-50). 462 patients (59%) had BOO in pressure-flow analysis (Schäfer 2-6). Both detrusor contractility parameters (BCI and Wmax) continuously rose with increasing BOO grade (Figure). Median BCI ranged from 73.3 in Schäfer 0 to 188.0 in Schäfer 6, whereas Wmax increased from 9.6 to 23.4 W/m2. In addition, there was a significant difference in BCI and Wmax when comparing non-BOO (Schäfer 0-1) with BOO patients (Schäfer 2-6), p<0.01. CONCLUSIONS Along with increasing BOO-grade, detrusor contraction power parameters –BCI and Wmax– continuously increased in a large group of male LUTS patients. We could, for the first time, confirm data obtained from animal studies in humans for the first time. Therefore, in a group of LUTS patients with different BOO grades, it is impossible to determine a single threshold value for detrusor contraction power to diagnose detrusor underactivity. Exact threshold values for BCI or Wmax in the subgroups of BOO have to be determined in future studies to define detrusor underactivity. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e885 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Kevin Rademakers More articles by this author Gommert van Koeveringe More articles by this author Matthias Oelke More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...