Will detrusor acontractility recover after medical or surgical treatment? A longitudinal long-term urodynamic follow-up.

Abstract

Patients with urinary retention due to detrusor acontractility (DA) might regain voiding efficiency (VE) after treatment. This study investigated the long-term outcomes and predictors of recovery following treatment. A total of 32 patients with DA were retrospectively identified and enrolled. DA was defined by Pdet .Qmax = 0 cmH2 Oand postvoid residual (PVR) > 300 ml determined through videourodynamic study (VUDS). All patients received medical or surgical treatment and were followed up for at least 3 months, during which repeat VUDS was conducted. Detrusor contractility recovery was confirmed when patients were able to void with a Pdet .Qmax ≥ 10 cmH2 O after treatment. Our patients comprised 22 women and 10 men (mean age, 73.2 ± 9.7 years; mean follow-up duration, 1.6 ± 1.8 [0.3-7.4] years). Follow-up VUDS revealed that 14 (43.9%) patients recovered from detrusor contractility, with five patients recovering within 1 year and nine after 1 year. Pdet .Qmax , voided volume, PVR, maximum flow rate, and VEsignificantly improved in both the recovery and nonrecovery groups. The recovery group had significantly better VE (p = .039) and significantly lower bladder compliance (74.2 ± 83.2 vs. 119 ± 82.6; p = .007) than the nonrecovery group. Receiver operating characteristic (ROC) analysis revealed an optimum bladder compliance cutoff value of<80 ml/cmH2 O for predicting detrusor contractility recovery with an area under the ROC curve of 0.780. Among the included patients with DA, 43.9% had detrusor contractility recovery after treatment, with bladder compliance of<80 ml/cmH2 O predicting bladder function recovery.