MP89-09 COEXISITING DEPRESSIVE SYMPTOMS DO NOT LIMIT THE BENEFITS OF CHRONIC NEUROMODULATION

Abstract

(residual urine), however they did not elaborate nor provide any metrics. The term “underactive bladder” has recently been suggested as the clinical correlate of DU. We sought to determine whether DU can be defined by a clinical symptom complex analogous to that for overactive bladder (OAB) symptoms. METHODS: This is a retrospective, IRB-approved review of patients with a urodynamic diagnosis of DU defined by a bladder contractility index (BCI) 40. For patients with a urodynamic diagnosis of BOO we defined DU if the product of detrusor contraction time and Qavg of 12 mL/S was < 90% of bladder capacity; ie, the bladder did not contract long enough to empty. Patients with an acontractile detrusor (AD) during urodynamics were considered to possibly have underactive detrusor. The data was analyzed two ways e by both including and excluding patients with an AD to assess the minimum and maximum incidence of UAB in our cohort. Patient symptoms were characterized using the lower urinary tract symptom score (LUTSS) and its sub-scores. Urodynamic data, including detrusor pressure at maximum flow (Pdet@Qmax), maximum detrusor pressure (pdetmax), detrusor contraction duration, maximum flow (Qmax), and post void residual (PVR) were collected. The affected cohort of patients was compared to a control group consisting of patients with a urodynamic diagnosis of bladder outlet obstruction (BOO). The two groups were compared using a student t-test. RESULTS: Of 4,272 consecutive patients the incidence of DU was 12%, AD 12%, and BOO 21%. The LUTSS questionnaires were completed in 392 patients. See table 1 for complete comparison data between both cohorts. In this cohort, the possible range of DU was 12% (DU alone) to 24% (DU þ AD). Aside from urodynamic criteria and PVR, the only differences between DU and BOO was a higher incidence of OAB symptoms in the latter, however, both groups had a high incidence of OAB. CONCLUSIONS: DU, unlike OAB, is a urodynamic diagnosis, not a clinical one. There is no symptom complex that correlates with UAB; rather, it should be based on urodynamics and PVR.