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Hermieu N, Chesnel C, Teng M, Xylinas E, Ouzaid I, Hermieu JF, Amarenco G, Hentzen C. Effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction. Neurourol Urodyn 2023; 42:445-452. [PMID: 36519669 PMCID: PMC10107853 DOI: 10.1002/nau.25113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/26/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Bladder outlet obstruction alters detrusor contractility, reducing the bladder's ability to respond to large filling with a risk of urinary retention. The objective was to assess the effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction. METHODS A prospective multicenter study in two pelviperineology departments. Male patients eligible for urodynamics (IPSS score > 7) were included from January to July 2022. In case of absence of bladder outlet obstruction on pressure-flow studies, they were secondarily excluded. The primary endpoint was the maximum isometric detrusor pressure during a stop-test, corresponding to detrusor contractility, measured at 3 filling volumes (50%, 75%, and 100% of cystometric capacity). RESULTS Fifty-two patients performed urodynamics, of whom 12 were excluded because of lack of obstruction or inability to perform the stop-test. Detrusor contractility was significantly higher for a 75% bladder filling than 50% and for a 75% filling than 100%, with a mean difference of 19.5; confidence interval (CI) 95% [14.3; 24.8] and 12.2; CI 95% [6.9; 17.5] cmH2 O respectively (p < 0,01). CONCLUSION In case of bladder outlet obstruction in men, detrusor contractility depends on bladder filling volume, with reduced contractility when the bladder was underfilled or overfilled. This phenomenon could help to explain the mechanisms of urinary retention in men with bladder outlet obstruction.
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Affiliation(s)
- Nicolas Hermieu
- GRC 01, GREEN Groupe de RecherchE cliniquE en Neuro-urologie, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France.,University Paris Cité, Paris, France.,Department of urology, AP-HP, Bichat Claude-Bernard Hospital, Paris, France
| | - Camille Chesnel
- GRC 01, GREEN Groupe de RecherchE cliniquE en Neuro-urologie, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Maëlys Teng
- GRC 01, GREEN Groupe de RecherchE cliniquE en Neuro-urologie, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Evanguelos Xylinas
- University Paris Cité, Paris, France.,Department of urology, AP-HP, Bichat Claude-Bernard Hospital, Paris, France
| | - Idir Ouzaid
- University Paris Cité, Paris, France.,Department of urology, AP-HP, Bichat Claude-Bernard Hospital, Paris, France
| | - Jean-François Hermieu
- University Paris Cité, Paris, France.,Department of urology, AP-HP, Bichat Claude-Bernard Hospital, Paris, France
| | - Gérard Amarenco
- GRC 01, GREEN Groupe de RecherchE cliniquE en Neuro-urologie, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
| | - Claire Hentzen
- GRC 01, GREEN Groupe de RecherchE cliniquE en Neuro-urologie, AP-HP, Hôpital Tenon, Sorbonne University, Paris, France
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Chen SF, Lee CL, Kuo HC. Change of Detrusor Contractility in Patients with and without Bladder Outlet Obstruction at Ten or More Years of follow-up. Sci Rep 2019; 9:18887. [PMID: 31827203 PMCID: PMC6906492 DOI: 10.1038/s41598-019-55386-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 11/27/2019] [Indexed: 11/09/2022] Open
Abstract
To analyze the change of detrusor contractility by investigating urodynamic characteristics with long term follow-up. This study retrospectively reviewed 166 lower urinary tract symptoms patients without bladder outlet obstruction (BOO) and 63 patients with BOO who underwent repeated urodynamic studies at the first time and more than 10 years later. The urodynamic parameters, bladder contractility index (BCI), and BOO index (BOOI) were compared before and after. As time goes by, detrusor pressure at maximum flow rate (PdetQmax) significantly decreased and post-void residual (PVR) volume significantly increased in both men and women. Full sensation, urge sensation, voided volume, and BCI significantly decreased. We also compared men with and without BOO, PdetQmax, maximum flow rate (Qmax), voided volume, and BCI all significantly decreased in both groups without difference. PVR increased greater in men with BOO after >10 years significantly (p = 0.036). Women with detrusor overactivity (DO) under antimuscarinic showed no significant BCI change compared to patients without DO (p = 0.228). Detrusor contractility decreases in men and women after >10 years of follow-up. However, this finding suggests that patients with BOO or DO under adequate medical treatment, detrusor contractility is not aggravated over 10 or more years of follow-up.
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Affiliation(s)
- Sheng-Fu Chen
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Cheng-Ling Lee
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan.
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Guzelsoy M, Aydos MM, Coban S, Turkoglu AR, Acibucu K, Demirci H. Comparison of the effectiveness of IPSS and VPSS without any help in LUTS patients: a prospective study. Aging Male 2018; 21:193-199. [PMID: 29228847 DOI: 10.1080/13685538.2017.1414178] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
AIM To compare the correlation of visual prostate symptom score (VPSS) and international prostate symptom score (IPSS). To investigate the effect of educational level and age in the responses to VPSS and IPSS. METHOD Three hundred and nine patients who gave consent and applied via LUTS to our institution were included in this study. They were requested to fill IPSS and VPSS. The patients were divided into two groups as middle-aged and elderly with a cutoff point of 65 years. They were divided into six groups based on educational level. SPSS was used for the statistical evaluation. RESULTS The mean age of the patients was 61.5 ± 8.9 years. The correlation was found between IPSS and VPSS (p < .05). Education was found not to contribute for answering IPSS and VPSS (p = .332 and .138, respectively). No difference was found between the middle-aged and elderly groups in terms of the rates of inability to answer IPSS and VPSS (p = .177 and .681, respectively). CONCLUSIONS There is a correlation between VPSS and IPSS. VPSS can be used as an auxiliary or alternative tool instead of IPSS in evaluating LUTS; however, has no superiority to IPSS in elderly group. Currently, the best option to exclude bias in illiterate group is VPSS.
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Affiliation(s)
- Muhammet Guzelsoy
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Mustafa Murat Aydos
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Soner Coban
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Ali Riza Turkoglu
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Kadir Acibucu
- a Department of Urology , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
| | - Hakan Demirci
- b Department of Family Medicine , Univesity of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital , Bursa , Turkey
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Reoperation Rates and Mortality After Transurethral and Open Prostatectomy in a Long-term Nationwide Analysis: Have We Improved Over a Decade? Urology 2018; 118:152-157. [PMID: 29733869 DOI: 10.1016/j.urology.2018.04.032] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/09/2018] [Accepted: 04/27/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To assess long-term reoperation rates and mortality after transurethral resection of the prostate (TURP) and open prostatectomy (PE) as therapy for lower urinary tract symptoms due to benign prostatic enlargement. METHODS The present study analyzes a nationwide database of all patients who underwent TURP/open PE during 2002-2006 and who were followed up for 8 years. Actuarial cumulative incidences of reoperation (TURP, urethrotomy, bladder neck incision) and death were calculated. Data were provided by the Austrian Public Health Institute. This series was compared with a previously published almost equally sized nationwide cohort that underwent surgery during 1992-1996 in Austria. RESULTS Between 2002 and 2006, a total of 21,674 patients underwent TURP (n = 20,388) or open PE (n = 1,286). At 8 years, the re-TURP rate after primary TURP was 8.3% vs 4.3% after open PE. The re-TURP rate was higher in the 80+ cohort. The overall endourological reintervention rate at 8 years was 12.7% for TURP and 8.8% for open PE. Reintervention rates did not improve compared with the 1992-1996 series. The 30-day in-hospital mortality rate was 0.1% for TURP and 0.2% for open PE. Mortality rates improved by approximately 20% compared with the 1992-1996 series. CONCLUSION In Austria, TURP rates remained stable between 1992 and 2006, paralleled by a 50% decline of open PE. Within a decade, mortality rates declined by 20%, yet reintervention rates remained unchanged.
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Yamada Y, Furusawa J, Sugimura Y, Kuromatsu I. Photoselective Vaporization of the Prostate: Long-Term Outcomes and Safety During 10 Years of Follow-Up. J Endourol 2016; 30:1306-1311. [DOI: 10.1089/end.2016.0522] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yasushi Yamada
- Department of Urology, Nagoya Central Hospital, Nagoya, Japan
| | - Jun Furusawa
- Department of Urology, Nagoya Central Hospital, Nagoya, Japan
| | | | - Isao Kuromatsu
- Department of Urology, Nagoya Central Hospital, Nagoya, Japan
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