BLADDER CONTRACTILITY AND INDICES OF RENAL FUNCTIONS IN PATIENTS WITH BENIGN HYPERPLASIA OF THE PROSTATE

Abstract

THE AIM of the investigation was to analyze interrelationships between urodynamic indices and the indices showing the kidney function in patients with benign hyperplasia of the prostate (BHP). PATIENTS AND METHODS. In 291 patients (mean age 61.3±0.7 years) with BHP the ultrasonic investigation of the kidneys, determination of the level of blood serum creatinin and urea were made as well as a urodynamic investigation with uroflowmetry and miction cystometry (investigation “pressure-flow”). The level of glomerular filtration (Rehberg test) was determined in 63 BHP patients. The results of miction cystometry for determination of detrusor contractility and intravesical obstruction (IVO) were interpreted using the W.Shafer (1990) method with the determination of the bladder emptying index by the method of P.Abrams (1999). RESULTS. The strength of contraction of detrusor influenced the blood creatinin level after operative treatment of BHP (r=0.54; p=0.48). The interrelationship was found between strength of contraction of detrusor (r=-0.2; p= 0.047) and urea level, i.e. the less bladder contractility is accompanied by higher urea level. The presence and degree of IVO did not influence the concentration of creatinin and urea in the blood (r=-0.16; p=0.22; r=-0.02; p=0.89). The less detrusor contractility is accompanied by lower level of glomerular filtration (r=0.41; p=0.035) and widening of the calycle-pelvic system (CPS) (r=0.41; p=0.035). The widening of the calycle-pelvic system is also influenced by the detrusor pressure with maximal unstable contraction (r=0.52; p=0.01) and the bladder volume with maximal unstable contraction (r=0.44; p=0.035). At the same time no correlation was observed (r=0.06; p=0.74) between hyperactivity of the detrusor and the widening of CPS. CONCLUSION. It was shown that the functional state of the upper urinary pathways in BHP patients was influence by a decrease of the contractile ability and powerful unstable contractions of the detrusor with large volumes of the bladder ratherthan by the IVO degree.