CONTRACTILITY OF THE BLADDER IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA

Abstract

THE AIM of the investigation was to assess the detrusor contractility in patients with benign prostatic hyperplasia (BPH). PATIENTS AND METHODS. Complex urological examination was performed in 540 BPH patients (mean age 64.1±0.7 years) in order to determine the detrusor contractility. It included urodynamic investigation with uroflowmetry and urination cystometry (investigation «pressure-flow»). Interpretation of the results of urination cystometry was made by the W.Shafer nomogram, the index of the bladder emptying was determined as a percent ratio of the urination volume to maximal cytometric bladder capacity. RESULTS. Decreased detrusor contractility was detected in 61.7% of BPH patients examined. Results of the determination of bladder contractility by W.Shafer nomogram depend on the degree of infravesical obstruction (IVO). The bladder emptying index does not depend on IVO or its degree and characterize both the bladder emptying degree and the duration of contraction. Such coexisting pathologies as ostechondrosis of the lumbar part of the spine and diabetes mellitus make the bladder emptying worse. The contractility can be reliably estimated but on the basis of a urodynamic investigation because the results of the generally used examination of BPH patients for the estimation of detrusor contractility are insufficiently informative. CONCLUSION. In a considerable number of BPH patients the impaired function of the lower urinary tracts is dependent on decreased contractility of the bladder rather than on infravesical obstruction, that must be taken into account in the decision on the treatment strategy.