Is Nocturia Associated With Detrusor Underactivity?

Abstract

OBJECTIVES:

Detrusor underactivity (DU) is diagnosed using urodynamic testing. We hypothesized that nocturia is associated with detrusor underactivity.

METHODS:

We performed a retrospective chart review of all women who underwent urodynamic testing at our institution between 2016 and 2018. Uroflowmetry and pressure-flow study parameters were compared between women with nocturia (≥2 voids/night) and without nocturia (0-1 void/night). Detrusor underactivity was diagnosed using 3 different criteria: (1) bladder voiding efficiency (BVE) of <90%, (2) bladder contractility index of <100, and (3) a composite of three urodynamic measures (Gammie criteria).

RESULTS:

Of 358 women, 172 (48%) were in the nocturia group and 186 (52%) were in the no nocturia group. On uroflowmetry, median postvoid residual volume was similar (20 mL) in both groups. Median maximum flow rate (15 vs 17 mL/s, P < 0.05) and average flow rate (6 mL/s vs 7 mL/s, P < 0.05) were significantly lower in the nocturia group compared with the no nocturia group. During pressure-flow study, a significantly greater proportion of women with nocturia were unable to void around the catheter (30% vs 27%, P < 0.01). The overall rate of DU varied with the criteria used: BVE (54%), bladder contractility index (41%), and Gammie criteria (7%). The rate of DU using the BVE criteria was significantly higher in the nocturia group (63% vs 48%, P < 0.01), but no significant differences were noted using the other criteria.

CONCLUSIONS:

Nocturia is associated with reduced voiding efficiency in women. The diagnosis of DU using urodynamics is challenging.

• Authors: Hannah T Ryles, Stephanie A Sansone, Pamela J Levin, Uduak U Andy, Heidi S Harvie, Lily A Arya
• Journal: Female pelvic medicine & reconstructive surgery (Female Pelvic Med Reconstr Surg) Vol. 27 Issue 9 Pg. e639-e644 (09 01 2021) ISSN: 2154-4212 [Electronic] United States
• PMID: 33651720 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 American Urogynecologic Society. All rights reserved.

Topics

• Female
• Humans
• Nocturia
• Retrospective Studies
• Urinary Bladder Neck Obstruction
• Urinary Bladder, Underactive
• Urodynamics