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Interrelationships of bladder compliance with age, detrusor instability, and obstruction in elderly men with lower urinary tract symptoms

1999; Wiley; Volume: 18; Issue: 1 Linguagem: Inglês

10.1002/(sici)1520-6777(1999)18

1520-6777

Stephan Madersbacher, Armin Pycha, Christoph Klingler, Christine Mian, Bob Djavan, Thomas M. Stulnig, Michael Marberger,

Urological Disorders and Treatments

Neurourology and UrodynamicsVolume 18, Issue 1 p. 3-13 Original Clinical Article Interrelationships of bladder compliance with age, detrusor instability, and obstruction in elderly men with lower urinary tract symptoms Stephan Madersbacher, Corresponding Author Stephan Madersbacher [email protected] Department of Urology, University of Vienna, Vienna, AustriaDepartment of Urology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, AustriaSearch for more papers by this authorArmin Pycha, Armin Pycha Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this authorChristoph H. Klingler, Christoph H. Klingler Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this authorChristine Mian, Christine Mian Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this authorBob Djavan, Bob Djavan Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this authorThomas Stulnig, Thomas Stulnig Department of Internal Medicine III, University of Vienna, Vienna, AustriaSearch for more papers by this authorMichael Marberger, Michael Marberger Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this author Stephan Madersbacher, Corresponding Author Stephan Madersbacher [email protected] Department of Urology, University of Vienna, Vienna, AustriaDepartment of Urology, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, AustriaSearch for more papers by this authorArmin Pycha, Armin Pycha Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this authorChristoph H. Klingler, Christoph H. Klingler Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this authorChristine Mian, Christine Mian Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this authorBob Djavan, Bob Djavan Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this authorThomas Stulnig, Thomas Stulnig Department of Internal Medicine III, University of Vienna, Vienna, AustriaSearch for more papers by this authorMichael Marberger, Michael Marberger Department of Urology, University of Vienna, Vienna, AustriaSearch for more papers by this author First published: 30 December 1998 https://doi.org/10.1002/(SICI)1520-6777(1999)18:1 3.0.CO;2-4Citations: 61AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Data on the interrelationships of bladder compliance (BC), detrusor instability (DI), and bladder outflow obstruction (BOO) in elderly men with lower urinary tract symptoms (LUTS) are scarce and were therefore assessed in this study. Principle inclusion criteria for this study were men aged ⩾50 years suffering from LUTS as defined by an International Prostate Symptoms Score (IPSS) of ⩾7 and a peak flow rate (Qmax) of ⩽15 ml/sec. Patients with previous surgery of the bladder, prostate, or urethra as well as a pathological neurourological status were excluded from this study. The following parameters were studied in all patients: IPSS, prostate volume calculated by transrectal ultrasonography, free uroflow study, post-void residual volume determined by transurethral catheterization, and a multichannel pressure flow study (pQS). A group of 170 men were included in the analysis. The mean BC in the overall group was 32 ± 2 ml/cm H2O (mean ± standard error of the mean [SEM]; range, 4–100 ml/cm H2O). In 36.5% of patients, BC was significantly reduced (⩽20 ml/cm H2O), and in a further 37.1%, it ranged from 20 to 40 ml/cm H2O. BC decreased statistically significantly (p < 0.05) in patients with advanced age, lower Qmax, higher voiding pressures, and larger prostates. In men with DI (n = 61), mean BC was significantly lower (22 ± 3 ml/cm H2O) compared to those without (37 ± 3 ml/cm H2O; p = 0.001; n = 109). Patients with severe BOO as defined by a linear passive urethral resistance relationship of ⩾3 (n = 109), had a significantly lower BC (23 ± 2 ml/cm H2O) compared to those without or minimal obstruction only (39 ± 3 ml/cm H2O; p = 0.0002; n = 61). Stepwise logistic regression analysis revealed that DI, a low bladder capacity, and a high maximum detrusor pressure were independent predictors of markedly reduced BC (<20 ml/cm H2O). BC is decreased in elderly men with high voiding pressures, BOO, and DI. The mechanism leading to the reduction of BC under these circumstances is largely unknown and could result from cytostructural alterations of the detrusor and changes in detrusor innervation. Neurourol. Urodynam. 18:3–15, 1999. © 1999 Wiley-Liss, Inc. Citing Literature Volume18, Issue11999Pages 3-13 RelatedInformation