Abstract: PD26-11
Sources of Funding: none

Introduction

Underactive bladder (UAB) is a symptom complex suggestive of detrusor underactivity (DU). However, DU can be diagnosed at present only on the basis of an invasive pressure flow study (PFS), which has hampered the development of clinical research and effective treatment for UAB. Noninvasive diagnostic approaches for DU could potentially facilitate the diagnosis and research of this field. We therefore investigated to identify the noninvasive predictive factors for DU using a large group of patients undergoing PFS.

Methods

We reviewed 2838 male patients who underwent PFS for lower urinary tract symptoms (LUTS). Age, International Prostate Symptom Score (IPSS), post-void residual volume (PVR), prostate volume (PV), and PFS parameters were obtained and analyzed. DU was defined as bladder contractility index <100. A multivariate logistic regression model was used to identify the factors associated with DU.

Results

Of the patients, 1355 patients (46%) were classified as having DU. In univariate analysis, the prevalence of DU was significantly increased with increasing age (P<0.001) and PVR elevation (P<0.001), but decreased with increasing PV (P<0.001). The assessment of subjective symptoms using IPSS questionnaire revealed that patients with DU had a statistically significant higher occurrence of frequency (P=0.01), intermittency (P=0.001) and weak stream (P=0.01) compared with non-DU patients. On the other hand, the occurrence of urgency symptom (P<0.001) was significantly lower in DU patients. In multivariate analysis, increasing age, PVR elevation, small PV, and several symptoms including frequency, intermittency, weak stream and urgency were selected as predictive factors for DU.

Conclusions

Several symptoms (frequency, intermittency, urgency and weak stream), increasing age, PVR elevation and small PV could be predictive factors of male DU. Combined evaluation of these factors might be useful for the diagnosis and better understanding of the clinical presentation of male DU.

Funding

none