DIAGNOSIS OF LOWER DETRUSOR CONTRACTILITY IN PATIENTS WITH BENIGN PROSTATE HYPERPLASIA
https://doi.org/10.24884/1561-6274-2010-14-2-72-77
Abstract
THE AIM. To develop a method for determining reduced detrusor contractility according to urodynamic studies in patients with benign prostate hyperplasia (BPH). PATIENTS AND METHODS. 138 patients with BPH, the average age of 63 ± 1.4 years old, had full urological examination including urodynamic investigation, which included uroflowmetry and micturating cystometry (the study of «pressure-flow»). Interpretation of the results of cystometry for determination of detrusor contractility and IVO was performed by W. Shafer and P. Abrams method. RESULTS. For the analysis were identified two groups of patients with very weak and the weak contractility of detrusor with Schafer nomogram. In the first group was 21 patient with BPH and low index discharge (less than 60%), the second – 36 patients with an index value discharge more than 60%. We assessed the reliability of indicators micturating cystometry in the diagnosis of lower detrusor contractility in patients with BPH. Based on the most reliable urodynamic parameters, we developed a formula for the diagnosis of lower detrusor contractility on the basis of a comprehensive performance assessment micturating cystometry. Diagnosis of detrusor contractility according to our proposed formula is based on a comprehensive assessment of the most informative indicators cystometry. In this regard, the reliability of diagnosis of detrusor contractility using the formula is higher, than in determining on the basis of evaluation of a single parameter cystometry. CONCLUSION. Based on the evaluation of urodynamic parameters, we developed a formula for the diagnosis to reduce detrusor contractility on the basis of a comprehensive evaluation of the parameters of micturating cystometry with detrusor contraction force, and the index discharge.
About the Authors
G. I. Daraghma
Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова
Russian Federation
Russian Federation
R. E. Amdy
Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова
Russian Federation
Russian Federation
References
1. Пушкарь ДЮ, Раснер ПИ. Алгоритм обследования и лечения больных с доброкачественной гиперплазией предстательной железы. Рус мед журн 2002; 10 (26): 3-6
2. Hindley RG, Brierly RD, Thomas PJ. Prostaglandin E2 and bethanechol in combination for treating detrusor underactivity. BJU Int 2004; 93 (1): 191-192
3. Griffiths DJ, McCracen PN, Harrisson GM et al. Urge incontinence and impaired detrusor contractility in the elderly. Neurourol Urodyn 2008; 21: 126-131
4. Monoski MA, Gonzalez RR, Sandhu JS et al. Urodynamic predictors of outcomes with photoselective laser vaporization prostatectomy in patients with benign prostatic hyperplasia and preoperative retention. Urology 2006; 68(2): 312-317
5. Gomes CM, Nunes RV, Araujo RM et al. Urodynamic evaluation of patients with lower urinary tract symptoms and small prostate volume. Urol Int 2008; 81(2): 129-134
6. Abrams P, Cardozo L, Fall M et al. The standardisation of terminology in lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodynam 2002; 21 (2): 167-178
7. Haylen BT, de Ridder D, Freeman RM et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 2010; 29(1): 4-20
8. Schafer W, Abrams P, Liao L et al. Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 2002; 21(3): 261-274
9. Shafer W. Basic principles and clinical application of advanced analysis of bladder voiding function. Urol Clin North Am 1990; 17 (2): 553-566
10. Abrams P. Bladder outlet obstruction index, blader contractility index and bladder voiding efficiency: three simple indices to define bladder voiding function. BJU Int 1999; 84: 745-750
11. De Gennaro M, Capitanucci ML, Mostello G et al. The changing urodynamic pattern from infancy to adolescence in boys with posterior urethral valves. BJU Int 2000; 85 (9): 1104-1108
12. Thomas AW, Cannon A, Bartlett E et al. The natural history of lower urinary tract dysfunction in men: the influence of detrusor underactivity on the outcome after transurethral resection of the prostate with minimum 10-year urodynamic follow-up. BJU Int 2004; 93(6): 745-750
Review
For citations:
Daraghma G.I., Amdy R.E. DIAGNOSIS OF LOWER DETRUSOR CONTRACTILITY IN PATIENTS WITH BENIGN PROSTATE HYPERPLASIA. Nephrology (Saint-Petersburg). 2010;14(2):72-77. (In Russ.) https://doi.org/10.24884/1561-6274-2010-14-2-72-77
Views:
282
Email this article 