PTU - Polskie Towarzystwo Urologiczne
list of articles:

CODE: 10.2 - Urodynamic assessment of patients with clinically diagnosed overactive bladder syndrome
Article published in Urologia Polska 2006/59/Suplement 1.

authors

Agata Kaliszczak, Marcin Słojewski, Artur Lemiński, Andrzej Sikorski
Katedra i Klinika Urologii PAM w Szczecinie

summary

Introduction. Overactivity of urinary bladder represents a group of symptoms associated with urine filling phase. Establishment of diagnosis is based upon the presence of disease symptoms or urodynamic assessment revealing involuntary contractions of detrussor muscle.
Objectives. Urodynamic characteristics of males and females in whom overactive bladder diagnosis was established on patient history.
Materials and methods. From 336 consecutive patients referred to urodynamic investigation, a group of 73 females and 16 males was selected with regard to patient history revealing symptoms of bladder overactivity. None of chosen patients presented involuntary detrussor contractions during urodynamic investigation. Study group comprised 73 women and 16 men with age ranging from 15 to 79 years and 31-75 years respectively. All patients were requested to fill micturition diary for 3 days. Entire study group underwent standard cystometric and pressure - flow examination. Urodynamic parameters like functional and cystometric bladder capacity, bladder compliance, bladder sensation and presence of bladder outlet obstruction were analysed together with data from patient's history. During cystometry cough and Valsalva provocation tests were performed.
Results. Mean age in study group was relatively low either in females (mean 50 years) and males (55.8 years). No significant differences between functional and maximal cystometric bladder capacity were found in female group (mean 372.2 ml vs 375 ml). In males cystometric bladder capacity was higher than functional bladder capacity by average 110 ml. Normal bladder sensation was found in 53.4% women and 62.5% men. Urine loss on provocation was revealed in 82.2% of women vs 12.5% of men. Bladder outlet obstruction was present in 68.7% of men. History for previous surgery was positive in 49.3% of women and 31.2% men. Concomitant diseases in women included commonly diagnosed arterial hypertension (41%). Men most commonly suffered from verterbral column diseases. Neurologic background of overactivity was revealed in only 2.7% of women. In 56.2% of men benign prostatic hyperplasia was found.
Conclusions. Entire study group was characterized by relatively low age. Only in males functional bladder capacity was significantly lower than maximal cystometric capacity. Majority of patients in both groups had normal bladder compliance and bladder sensation. In men bladder overactivity is most commonly associated with benign prostatic hyperplasia, while in women with stress urinary incontinence. History of previous surgery might be considered a predisposing factor for bladder overactivity in females.