The Analysis of the Urodynamic Study in Detrusor Instability

Jeong, Ho Hyeon; Lee, Jurng Gu

Abstract

Detrusor instability is defined as involuntary detrusor contraction above 15 cmH2O during normal bladder filling without neuralgic disorder. Recently clinical evaluation of the patients with detrusor instability was being made more commonly by urodynamic study. We analysed urodynamic study (filling and voiding cystometry) on 26 patients diagnosed as BPH with detrusor instability (Group A) on the Department of Urology, Korea University Haehwa Hospital during the period from September. 1988 to July, 1989. The results were compared with the 22 patients who were diagnosed as BPH without detrusor instability (Group B). The results was followed : 1. In Group A, bladder volume of urge to void (148.81 +- 87.61 ml) and maximum cystometric capacity (231.80 +- 116.49ml) were lower than the results of Group B (232.41 +- 101.69ml and 429.82 +- 121.16ml) in filling cystometry. 2. In Group A, the compliance was low in 21 (<20ml/cm H20) and mean compliance was 10.38 +- 10.29ml/cm H20. It was much lower than that of the Group B (28.66 +- 17.19ml/cm H20) (p <0.005). 3. In voiding cystometry, typical obstructive pattern was 32 cases and 11 cases were failed due to urge incontinence during filling cystometry. 4. Among 26 cases of BPH with detrusor instability, Oxybutynin were given on 12 cases in which postoperative incontinence were persisted in spite of UTI control. 5. 10 (83.3%) in 12 cases of BPH group treated with Oxybutynin showed subjective improvement of irritative voiding symptoms. 6. Detrusor pressure at maximum cystometric capacity were 74.2 +- 29.7 cmH20 in Group A and 45.2 +- 25.7 cmH20 in Group B. (p<0.005).