Bladder function in obstructed men – does age matter?

Beltrame, Fabricio; Ferreira, Fabio Thadeu; Lorenzetti, Fábio; Dambros, Mara Celia; Bisogni, Sérgio; Dambros, Míriam

doi:10.3109/13685538.2015.1025377

Cited by 9 publications

(4 citation statements)

References 31 publications

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“…Beltrame supposed that older men with LUTS had significant decreases in voiding efficiency, which might be due to storage dysfunction rather than impaired detrusor contractility or bladder outlet obstruction 8 . Due to lack of report of long term follow-up of the change of detrusor contractility, we tried to investigate a cohort of men and women who had undergone videourodynamic studies (VUDS) before and after more than 10 years to evaluate the changes in detrusor contractility over time.…”

Section: Introductionmentioning

confidence: 99%

Change of Detrusor Contractility in Patients with and without Bladder Outlet Obstruction at Ten or More Years of follow-up

Chen

Lee

Kuo

2019

Sci Rep

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To analyze the change of detrusor contractility by investigating urodynamic characteristics with long term follow-up. This study retrospectively reviewed 166 lower urinary tract symptoms patients without bladder outlet obstruction (BOO) and 63 patients with BOO who underwent repeated urodynamic studies at the first time and more than 10 years later. The urodynamic parameters, bladder contractility index (BCI), and BOO index (BOOI) were compared before and after. As time goes by, detrusor pressure at maximum flow rate (PdetQmax) significantly decreased and post-void residual (PVR) volume significantly increased in both men and women. Full sensation, urge sensation, voided volume, and BCI significantly decreased. We also compared men with and without BOO, PdetQmax, maximum flow rate (Qmax), voided volume, and BCI all significantly decreased in both groups without difference. PVR increased greater in men with BOO after >10 years significantly (p = 0.036). Women with detrusor overactivity (DO) under antimuscarinic showed no significant BCI change compared to patients without DO (p = 0.228). Detrusor contractility decreases in men and women after >10 years of follow-up. However, this finding suggests that patients with BOO or DO under adequate medical treatment, detrusor contractility is not aggravated over 10 or more years of follow-up.

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Section: Introductionmentioning

confidence: 99%

Change of Detrusor Contractility in Patients with and without Bladder Outlet Obstruction at Ten or More Years of follow-up

Chen

Lee

Kuo

2019

Sci Rep

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“…The influence of age on contractility is still controversial today. Studies by Beltrame et al in 2015 in humans and Hardy et al in 2019 in mice did not show a relationship between age and contractility, 16 , 17 whereas a 2010 review of the literature concluded that contractility progressively decreased with age. 18 Prostatic volume was also not correlated with contractility.…”

Section: Discussionmentioning

confidence: 95%

Effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction

Hermieu

Chesnel

Teng

et al. 2022

Neurourology and Urodynamics

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Introduction: Bladder outlet obstruction alters detrusor contractility, reducing the bladder's ability to respond to large filling with a risk of urinary retention. The objective was to assess the effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction.Methods: A prospective multicenter study in two pelviperineology departments. Male patients eligible for urodynamics (IPSS score > 7) were included from January to July 2022. In case of absence of bladder outlet obstruction on pressure-flow studies, they were secondarily excluded. The primary endpoint was the maximum isometric detrusor pressure during a stop-test, corresponding to detrusor contractility, measured at 3 filling volumes (50%, 75%, and 100% of cystometric capacity).Results: Fifty-two patients performed urodynamics, of whom 12 were excluded because of lack of obstruction or inability to perform the stop-test. Detrusor contractility was significantly higher for a 75% bladder filling than 50% and for a 75% filling than 100%, with a mean difference of 19.5; confidence interval (CI) 95% [14.3; 24.8] and 12.2; CI 95% [6.9; 17.5] cmH 2 O respectively (p < 0,01). Conclusion:In case of bladder outlet obstruction in men, detrusor contractility depends on bladder filling volume, with reduced contractility when the bladder was underfilled or overfilled. This phenomenon could help to explain the mechanisms of urinary retention in men with bladder outlet obstruction.

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“…There was an independent age-associated decline in contractility. Literature on the association of age and bladder contractility is conflicting [11], but others studies have reported a similar association with age [7,8,12]. Age can impact bladder contractility by several possible mechanisms.…”

Section: Figurementioning

confidence: 99%

Association of Age With Lower Urinary Tract Function in Adult Men Presenting for Urodynamics: A Database Analysis

Sinha¹,

Matina²

2021

September 2021

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Background: Knowledge regarding lower urinary tract function in adult men could help in making informed choices. Few studies have examined the entire spectrum of adult males. Methods: This is a retrospective analysis of all adult men with refractory non-neurogenic urinary symptoms presenting to a tertiary center over 9 years. International Continence Society defined indices bladder outlet obstruction index (BOOI) and bladder contractility index (BCI) were calculated with established classification. Storage abnormality was defined as presence of detrusor overactivity, poor compliance (< 20mL per cm H20) or both. Data were analyzed by non-parametric tests using SPSS (version 20.0.0, Armonk NY ) (P < 0.05 significant; 2-tailed). Where appropriate, correction for multiple hypothesis testing was applied. Results: A total of 1596 men (range 18 to 91 years, median 51.0 years; IQR 34 to 64 years) were eligible. Median BCI and BOOI were 99.5 and 37.0, respectively, and a storage abnormality was noted in 41.7%. On multivariate analysis, age was significantly associated with urodynamic findings. While not strictly linear, for each 10 years increase in age, on average, the BCI fell 2.4 points and the BOOI increased by 2.4 points. Increasing age was also associated with increasing odds of finding a storage abnormality (OR 1.015; 95%CI 1.008 to 1.022; P < 0.001). On post hoc analysis (Bonferroni correction), men under 30 years were least likely of any group to show obstruction (30.3%; median BOOI 26). Conclusions: Adult men with refractory urinary symptoms show age-associated differences in urodynamic findings. An awareness of these trends can help take more informed decisions in clinical care.

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Bladder function in obstructed men – does age matter?

Abstract: Age-related changes in voiding function might not be a result of impaired detrusor contractility or increased outflow obstruction, intrinsic causes must be suspected. Changes in the storage function of the bladder represent specific pathophysiological mechanisms influenced by aging.

Cited by 9 publications

References 31 publications

Change of Detrusor Contractility in Patients with and without Bladder Outlet Obstruction at Ten or More Years of follow-up

Change of Detrusor Contractility in Patients with and without Bladder Outlet Obstruction at Ten or More Years of follow-up

Effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction

Association of Age With Lower Urinary Tract Function in Adult Men Presenting for Urodynamics: A Database Analysis

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