Is There a Correlation Between the Presence of Idiopathic Detrusor Overactivity and the Degree of Bladder Outlet Obstruction?

Oh, Mi Mi; Choi, Hoon; Park, Min Gu; Kang, Seok Ho; Cheon, Jun; Bae, Jae Hyun; Moon, Du Geon; Kim, Je Jong; Lee, Jeong Gu

doi:10.1016/j.urology.2010.05.034

Cited by 29 publications

(22 citation statements)

References 21 publications

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“…This is mainly due to significant changes in bladder function and autonomic nerve degeneration in the preoperative state [11]. These findings are in accordance with the smaller bladder capacity noted in the voiding diary, which occurs because of a significant increase in collagen fibers in the submucosa and around the neurovascular bundles caused by aging [12]. Additional presumptive effects on the bladder could be caused by BOO and aging, resulting in bladder ischemia by hypertrophy, leading to small bladder capacity [13].…”

Section: Discussionsupporting

confidence: 52%

Prediction of Persistent Storage Symptoms after Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement

et al. 2014

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Objective: To identify the prognostic factors causing persistent storage symptoms following transurethral resection of the prostate in patients with benign prostatic enlargement (BPE). Methods: A total of 116 men with symptomatic BPE requiring surgery were enrolled in the study between January 2011 and December 2012. The patients underwent basic clinical evaluations including transrectal ultrasound, International Prostate Symptom Score and urodynamic study. After 6 months, International Prostate Symptom Score and uroflowmetry were rechecked. The definition of persistent storage symptoms was patients with storage scores >7 points. Logistic regression analysis and receiver operating characteristic analysis were conducted. Results: The 116 patients were divided into a persistent storage symptom-positive group (n = 33) and a storage symptom-negative group (n = 83). Multivariate analysis showed that the degrees of worse initial storage symptoms (odds ratio [OR] = 8.32), small bladder capacity (OR = 4.31), impaired detrusor contractility (OR = 2.96) and age (OR = 1.05) were consistently associated with persistent storage symptoms. Conclusions: This short-term study confirms the positive and consistent correlations between the baseline degree of worse initial storage symptoms, bladder capacity, detrusor contractility and age and the improvement in storage symptoms.

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Section: Discussionsupporting

confidence: 52%

Prediction of Persistent Storage Symptoms after Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement

et al. 2014

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“…This finding was in accordance with our previous study which revealed a positive correlation between the presence of IDO and BOOI. 8 There was an increasing probability of IDO with increasing BOOI as shown in linear-by-linear association test (P50.041), confirmed by a recent report by Oelke et al 9 They demonstrated that with increasing BOO grade, there was an increasing probability of detusor overactivity and tendency toward an earlier appearance and higher amplitude of detusor overactivity.…”

Section: Discussionsupporting

confidence: 61%

Is there a correlation between the outcome of transurethral resection of prostate and preoperative degree of bladder outlet obstruction?

Oh¹,

Kim²,

Kim³

et al. 2011

Asian J Androl

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To compare the impact of transurethral resection of prostate (TURP) on symptom scores and maximal flow rates (Qmax) in patients with equivocal bladder outlet obstruction (BOO) and definite BOO and to assess the relationship between the surgical outcomes and degree of preoperative BOO, we prospectively evaluated men with lower urinary tract symptoms and bladder outlet obstruction index (BOOI) greater than 20, who were refractory to conventional medical treatment and underwent TURP. Urodynamic evaluation, International Prostate Symptom Score (IPSS), uroflowmetry, post-void residual volume (PVR) check and transrectal ultrasound were performed. 20,BOOI,40 was defined as equivocal BOO and BOOIo40 as definite BOO. Changes of IPSS, Qmax, PVR and correlation analysis was performed between the degree of improvement of Qmax, subdomains of IPSS and BOOI. Fifty-four patients showed equivocal BOO and 80 patients showed definite BOO. Preoperatively equivocal BOO group and definite BOO group showed significant differences in maximal bladder capacity and prevalence of detrusor overactivity, whereas no difference was noted in prostate volume. Postoperatively both groups showed improvements in Qmax, obstructive (IPSSO) and irritative (IPSSI) subdomain of IPSS, but the degree of improvement in Qmax and IPSSI subdomain was statistically significantly greater in definite BOO group. The degree of improvement of Qmax and IPSSI showed weak correlation with preoperative BOOI. As a weak correlation was identified between preoperative degree of BOO and outcome of TURP, other factors other than BOOI such as severity of patients' symptoms should be considered in deciding treatment modality.

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“…Because of the sustained BOO, the newly synthesized collagen fibers will gradually decompose into short-chain collagens, leading to gradual aggravation of collagen deposition; short-chain collagens lack good elasticity, and along with the increase in collagen deposition, the ECM gradually loses its elasticity, resulting in deceased bladder wall constriction and compliance [6,7,19]. Several clinical and pathological studies have pointed out that the ECM/cell ratio is an important indicator of bladder function [18,20,21]. The higher the ratio, the poorer the bladder compliance and the more severe the patient's LUTS.…”

Section: Discussionmentioning

confidence: 99%

The Antimuscarinic Agent Tolterodine Regulates Bladder Extracellular Matrix in Partial Bladder Outlet Obstruction in Rats

Yang

Luo

Lin

et al. 2018

Cell Physiol Biochem

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Background/Aims: Antimuscarinic agents can delay the progression of bladder dysfunction caused by bladder outlet obstruction (BOO). To date, the relationship between muscarinic receptor activity and the bladder extracellular matrix (ECM) remains unclear. Thus, an animal model of partial BOO (PBOO) in female rats was established to explore the variation in bladder wall ECM proteins under PBOO conditions with antimuscarinic agent administration. Methods: Rats were randomly divided into three groups: sham, PBOO, and PBOO plus tolterodine. Picrosirius red staining was used to examine the smooth muscle and collagen content of bladder samples. Gene microarray and RT-PCR were performed to survey the expression of ECM proteins, receptors, and metabolism regulators in the rat bladder. Positive results were further evaluated by immunohistochemistry. Results: Picrosirius red staining showed that smooth muscle volume significantly increased in the PBOO and PBOO plus tolterodine groups (p < 0.05), while collagen significantly increased in the PBOO group (p < 0.05) but not in the PBOO plus tolterodine group. Gene microarray and RT-PCR revealed that none of the collagen subtypes exhibited significant changes after PBOO establishment and tolterodine administration. However, matrix metalloproteinases (MMPs) increased significantly in the PBOO plus tolterodine group (p < 0.05). Additionally, PBOO inhibited the expression of noncollagen ECM proteins in the rat bladder wall, while tolterodine induced the expression of noncollagen ECM proteins and ECM receptors. Conclusions: Tolterodine decreased the volume of collagen in PBOO rat bladder wall, possibly via MMPs, and regulated the expression of ECM proteins and receptors.

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Is There a Correlation Between the Presence of Idiopathic Detrusor Overactivity and the Degree of Bladder Outlet Obstruction?

Cited by 29 publications

References 21 publications

Prediction of Persistent Storage Symptoms after Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement

Prediction of Persistent Storage Symptoms after Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement

Is there a correlation between the outcome of transurethral resection of prostate and preoperative degree of bladder outlet obstruction?

The Antimuscarinic Agent Tolterodine Regulates Bladder Extracellular Matrix in Partial Bladder Outlet Obstruction in Rats

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