Impaired detrusor contractility in community-dwelling elderly presenting with lower urinary tract symptoms.

Abstract

OBJECTIVES:

To determine the prevalence of impaired detrusor contractility (IDC) with and without detrusor hyperactivity (DH) among community-dwelling elderly with lower urinary tract symptoms and to identify which patients are at a greater risk of having a hypocontractile detrusor.

METHODS:

We performed a retrospective chart review of all patients 70 years old or older with storage and/or voiding lower urinary tract symptoms who had undergone urodynamic pressure-flow studies in a urodynamic referral center during a 2-year period.

RESULTS:

During the study period, 181 patients (82 men [45%] and 99 women [55%]), aged 70 years or older (mean age 75.7 +/- 4.8), underwent urodynamic studies. IDC was detected in 39 (48%) of the 82 men and in 12 (12%) of the 99 women. Two thirds of the men and one half of the women with IDC also had involuntary detrusor contractions during the filling phase and/or low bladder compliance. The prevalence of IDC/DH-IDC was significantly greater in those with a history of urinary retention and an indwelling urethral catheter.

CONCLUSIONS:

Detrusor-impaired contractility is an important pathophysiologic mechanism in older patients with lower urinary tract symptoms, especially in men. Establishing the diagnosis by urodynamic pressure-flow studies is crucial for determining treatment--potentially harmful to this vulnerable population--from objective parameters rather than by empirical decisions.

• Authors: Joseph Abarbanel, Esther-Lee Marcus
• Journal: Urology (Urology) Vol. 69 Issue 3 Pg. 436-40 (Mar 2007) ISSN: 1527-9995 [Electronic] United States
• PMID: 17382138 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Female
• Humans
• Male
• Muscle Contraction (physiology)
• Retrospective Studies
• Urinary Bladder (physiopathology)
• Urinary Bladder, Overactive (physiopathology)
• Urination Disorders (physiopathology)
• Urodynamics