Voiding dysfunction and urodynamic abnormalities in elderly patients

Abstract

Lower urinary tract dysfunction is a major cause of morbidity and decreased quality of life in elderly men and women. With the progressive aging of the population, it is important to understand common micturitional disorders that may occur in this population. Most urinary problems in the elderly are multifactorial in origin, demanding a comprehensive assessment of the lower urinary tract organs, functional impairments, and concurrent medical diseases. Urodynamics is a highly valuable tool in the investigation of elderly patients with lower urinary tract symptoms. Urodynamic tests are not always necessary, being indicated after excluding potentially reversible conditions outside the urinary tract that may be causing or contributing to the symptoms. Although urodynamic tests may reveal common diagnoses such as bladder outlet obstruction and stress urinary incontinence in the elderly population, findings such as detrusor overactivity and impaired detrusor contractility are common and have important prognostic and therapeutic implications. The purpose of this article is to describe common urologic problems in the elderly and review the indications for and clinical aspects of urodynamic studies in these conditions.

Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance

“…Such symptoms usually become more pronounced in PD due to the bradykinesia, thus leading to a decrease in patients' quality of life 15 . PD patients with lower urinary tract symptoms require urodynamic evaluation to establish the neurologic origin of the urinary dysfunctions 16 . Detrusor hyperreflexia or detrusor hyperactivity (DH) is determined by autonomic mechanisms that cause spontaneous involuntary contractions of the bladder detrusor muscle, being the most common urodynamic finding in PD patients with urinary dysfunction 17 and can be detected by cystometry during the bladder filling phase 18,19 .…”

Urodynamics in a community-dwelling population of females 80 years or older: which motive? Which diagnosis?

“…Age related changes in the female LUT involve both bladder, impaired contractility or overactivity, and urethra, decreased urethral closure pressure and urogenital atrophy. Some studies have been conducted in order to evaluate the effect of age on the LUT function (8)(9)(10)(11)(12). In fact, these studies seldom concerned the oldest subgroup and were mainly devoted to the role and effects of detrusor overactivity (8,11,12).…”

A Enfermagem no Sistema Único de Saúde: Desenvolvendo saberes e fazeres na formação profissional

“…A associação entre a IU e a demência sugere que não podem ser causalmente relacionadas, existindo outras etiologias com múltiplas causas tratáveis. Doenças como a hemiplegia, a ataxia, e o acidente vascular cerebral, entre outros, podem ocasionar a hiperatividade do músculo detrusor em idosos, com consequente IU (CASTLEDEN; CHEATER 2000; DUBEAU et al, 2001;TAMANINI et al, 2009;RODRIGUES;MENDES 1994;REIS et al, 2003;SILVA;SANTOS, 2005;BOTLERO et al, 2009;BUMP;NORTON, 1998;NYGAARD;BARBER;BURGIO, 2008;ROBLES, 2006;BARTH et al, 2010;COLL;GUERRA, 2005;GOMES;ARAP;ROCHA, 2004).…”