Long-Term Monitoring of Bladder Pressure in Chronic Retention of Urine: The Relationship between Detrusor Activity and Upper Tract Dilatation

Abstract

We investigated 41 men with chronic retention of urine owing to bladder outflow obstruction by long-term monitoring of bladder pressure and conventional cystometry to determine the relationship between detrusor pressure and upper tract dilatation. We confirmed that high pressures during conventional filling cystometry were common in men with upper tract dilatation. However, important differences were demonstrated between long-term monitoring and conventional cystometry. The pressure increase during the natural filling phase of long-term monitoring was significantly smaller than that during conventional cystometry. Detrusor instability was found in 88 per cent of the men during long-term monitoring but in only 51 per cent during conventional cystometry (p less than 0.001). High frequency unstable detrusor contractions during long-term bladder pressure monitoring were associated significantly with upper tract dilatation (p less than 0.0001) and correlated significantly with impairment of glomerular filtration rate (rs equals -0.7339, p less than 0.001).

Bladder compliance in patients with benign prostatic hyperplasia

“…According to some reports, the pressure increase during the natural storage phase of long-term monitoring was significantly smaller than that during conventional cystometry [Styles et al, 1986[Styles et al, , 1988Webb et al, 19921. Artifacts may be introduced with the nonphysiological filling rate used during conventional cystometry.…”

“…Artifacts may be introduced with the nonphysiological filling rate used during conventional cystometry. However, there are many reports that low compliance in the storage phase of medium fill conventional cystometry is significantly associated with upper urinary tract dilatation [Styles et al, 1986[Styles et al, , 1988,; Ghoniem et al, 1990;Bloom et al, 1990;Yokoyama et al, 19961. In the storage phase of the bladder, the faster filling medium might continuously stimulate the sensory ending of the bladder wall, resulting in low compliance via the spinal reflex arc.…”

Benign Prostate Hyperplasia and Chronic Kidney Disease

“…Rule et al, defined chronic urinary retention (CUR) as a post-void residual urine (PVR) higher than 100 mL, and reported that CUR was significantly associated in CKD in community-dwelling men. For years it has been well described that large volumes (»300 mL) affect renal function in advanced BPH (Styles, Neal et al 1988;Rule, Lieber et al 2005;Yamasaki 2010). …”

Assessment of Serum Prostate Specific Antigen, Some Renal Indices and Uric Acid Levels in Subjects with Benign Prostatic Hyperplasia at Lokoja, Nigeria

“…This inheritance is because binding of Dihydrotestosterone to nuclear androgen receptors to signal growth of prostate gland is a function of genetic makeup of such individual. One possible risk factor for chronic kidney disease may be benign prostatic hyperplasia (BPH) [2][3][4]. BPH has been described as a common clinical syndrome in older men characterized by bladder outlet obstruction, lower urinary tract symptoms, and benign prostatic enlargement [5].…”