Identifying occult bladder outlet obstruction in women with detrusor-underactivity-like urodynamic profiles.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
01 12 2021
01 12 2021
Historique:
received:
11
05
2021
accepted:
19
11
2021
entrez:
2
12
2021
pubmed:
3
12
2021
medline:
20
1
2022
Statut:
epublish
Résumé
Voiding dysfunction can result from detrusor underactivity (DU), bladder outlet obstruction (BOO), or both. Conceptually, women with high-pressure low-flow urodynamic profiles are diagnosed with BOO without DU. However, the possibility of BOO is often neglected in women with DU-like (low-pressure low-flow) urodynamic (UDS) profiles. By reviewing the videourodynamic studies (VUDS) of 1678 women, our study identified the key factors suggesting urodynamic BOO (determined by radiographic evidence of obstruction) in women with DU-like UDS profiles (Pdet.Qmax < 20 cmH2O and Qmax < 15 mL/s). In 355 women with DU-like UDS profiles, there were 70 (19.7%) with BOO and 285 (80.3%) without BOO. The BOO group had predominantly obstructive symptoms. The BOO group showed significantly decreased bladder sensation, lower detrusor pressure (Pdet.Qmax), lower flow rate (Qmax), smaller voided volume, and larger post-voiding residual (PVR) compared to the non-BOO group. In multivariate analysis, volume at first sensation, Qmax, PVR, and detrusor overactivity (DO) remained independent factors for BOO. The receiver operating characteristic (ROC) areas for the parameters were largest for PVR (area = 0.786) and Qmax (area = 0.742). The best cut-off points were 220 mL for PVR and 4 mL/s for Qmax. Our findings provide simple indicators for BOO in women with DU.
Identifiants
pubmed: 34853346
doi: 10.1038/s41598-021-02617-0
pii: 10.1038/s41598-021-02617-0
pmc: PMC8636520
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
23242Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. The Author(s).
Références
Curr Urol Rep. 2014 Sep;15(9):436
pubmed: 25059639
Int Urol Nephrol. 2013 Aug;45(4):989-94
pubmed: 23722818
N Engl J Med. 1989 Jan 5;320(1):1-7
pubmed: 2909873
Ann Pharmacother. 2014 Jun;48(6):711-22
pubmed: 24615630
J Urol. 1999 May;161(5):1535-40
pubmed: 10210391
Int Urol Nephrol. 2021 Feb;53(2):199-204
pubmed: 33074461
J Urol. 2000 Jun;163(6):1823-8
pubmed: 10799191
Eur Urol. 2014 Feb;65(2):389-98
pubmed: 24184024
Neurourol Urodyn. 2018 Jan;37(1):368-378
pubmed: 28666055
Eur Urol. 2017 Sep;72(3):402-407
pubmed: 28400168
J Obstet Gynaecol Res. 2016 May;42(5):560-5
pubmed: 27108667
Urology. 2014 Feb;83(2):428-32
pubmed: 24231217
Int Urogynecol J. 2020 Dec;31(12):2557-2564
pubmed: 32556406
Neurourol Urodyn. 2019 Feb;38(2):433-477
pubmed: 30681183
Low Urin Tract Symptoms. 2019 Jan;11(1):72-77
pubmed: 28990728
Eur Urol. 2016 Feb;69(2):361-9
pubmed: 26318706
Urology. 1998 Mar;51(3):408-11
pubmed: 9510344
Curr Opin Urol. 2002 Jul;12(4):311-6
pubmed: 12072652
Curr Opin Urol. 2016 Jul;26(4):334-41
pubmed: 27214578
Neurourol Urodyn. 2002;21(2):167-78
pubmed: 11857671
Br J Urol. 1988 Jan;61(1):36-9
pubmed: 3342298
J Formos Med Assoc. 2000 May;99(5):386-92
pubmed: 10870328
Rev Urol. 2005;7 Suppl 6:S14-21
pubmed: 16986024
J Formos Med Assoc. 2016 Sep;115(9):807-13
pubmed: 26375777
BMC Urol. 2018 Mar 9;18(1):15
pubmed: 29519236
Neurourol Urodyn. 2018 Nov;37(8):2928-2931
pubmed: 30203560
Korean J Urol. 2012 May;53(5):342-8
pubmed: 22670194