Investig Clin Urol.  2021 Jul;62(4):477-484. 10.4111/icu.20200471.

Prevalence and urodynamic characteristics of detrusor overactivity with impaired contractility in the community-dwelling elderly with non-neurogenic lower urinary tract symptoms: Is it from a single or two independent bladder dysfunctions?

• Jeong SJ
• Lee M
• Song SH
• Kim H
• Choo MS
• Cho SY
• Oh SJ
• SEOUL Study Group

• KMID: 2516929
• DOI: http://doi.org/10.4111/icu.20200471

Abstract

Purpose
To identify the prevalence of detrusor overactivity with impaired contractility (DOIC) in the community-dwelling elderly and explore whether it is from a single or two independent bladder dysfunctions.
Materials and Methods
Based on a 10-year urodynamic database of the SEOUL Study Group, elderly patients who met inclusion criteria were selected. Bladder sensation, capacity, and compliance were designated as evaluation elements for storage function, and free maximal flow rate (Q_max) and post void residual volume, detrusor pressure at maximal flow (P_detQmax), and bladder voiding efficiency for voiding function.
Results
The prevalence rate of DOIC was 18.8% and 5.5% among 2,571 men and 688 women, respectively, and increased significantly with age. In men, patients with DOIC showed no differences in storage parameters and significantly lower free Q_max and P_detQmax among voiding parameters, compared to those with detrusor overactivity (DO) only. Compared to men with detrusor underactivity (DU) only, those with DOIC had worse parameters in the majority of storage and voiding functions. In women, most of the storage and voiding functions were worse in patients with DOIC than in those with DO only. On the other hand, women with DU showed lower P_detQmax and worse voiding functions than those with DOIC, although some parameters did not reach statistical significance.
Conclusions
It seems that DOIC is developed from a coincidental combination of two independent DO and DU in men. In contrast, DOIC is likely to be an intermediate step during the process of progression from DO to DU in women.

Keyword

Detrusor underactivity; Elderly; Overactive detrusor; Urodynamics