Potential predictors of detrusor underactivity in a urology outpatient clinic: a 5-year single center experience study

Authors

  • Soefiannagoya Soedarman Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Harrina Erlinati Rahardjo Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0003-4458-4055

DOI:

https://doi.org/10.13181/mji.oa.215102

Keywords:

detrusor underactivity, urinary bladder, urodynamics
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Abstract

BACKGROUND Detrusor underactivity (DU) is diagnosed using urodynamics, which caused by a combination of strength and duration of the bladder muscle and resulted in prolonged bladder emptying. Invasive urodynamics, which are limited in many clinical settings, should be performed efficiently in high-risk patients to reduce the risk of emerging complications during and after the procedure. Therefore, this study was aimed to identify the potential predictors of DU for limited clinical settings.

METHODS This retrospective study was retrieved from the medical records of patients who underwent urodynamics in the Department of Urology, Cipto Mangunkusumo Hospital from 2015 to 2020. Age, sex, bladder capacity, bladder compliance, bladder outlet obstruction, history of stroke, diabetes mellitus (DM) status, and neurological abnormalities were analyzed using chi-square and Mann–Whitney to examine the potential predictors of DU. The odds ratio (OR) of each factor was also calculated. Logistic regression was furtherly used for the analysis.

RESULTS A total of 649 patients were included in this study. Male (OR = 1.74, 95% CI = 1.28–2.38) and DM patients (OR = 2.06, 95% CI = 1.36–3.11) had a higher risk of DU, while bladder outlet obstruction (OR = 0.54, 95% CI = 0.39–0.76) was the protective factor of DU. Furthermore, multivariate analysis showed that the potential predictors of DU were male (OR = 1.903, 95% CI = 1.37–2.64), DM (OR= 1.899, 95% CI = 1.22–2.95), and bladder outlet obstruction (OR = 0.32, 95% CI = 0.32–0.65).

CONCLUSIONS Age, sex, bladder outlet obstruction, and history of DM could become the predictors of DU.

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References

Osman NI, Esperto F, Chapple CR. Detrusor underactivity and the underactive bladder: a systematic review of preclinical and clinical studies. Eur Urol. 2018;74(5):633-43. https://doi.org/10.1016/j.eururo.2018.07.037

Jeong SJ, Kim HJ, Lee YJ, Lee JK, Lee BK, Choo YM, et al. Prevalence and clinical features of detrusor underactivity among elderly with lower urinary tract symptoms: a comparison between men and women. Korean J Urol. 2012;53(5):342-8. https://doi.org/10.4111/kju.2012.53.5.342

Gammie A, Kaper M, Dorrepaal C, Kos T, Abrams P. Signs and symptoms of detrusor underactivity: an analysis of clinical presentation and urodynamic tests from a large group of patients undergoing pressure flow studies. Eur Urol. 2016;69(2):361-9. https://doi.org/10.1016/j.eururo.2015.08.014

Osman NI, Chapple CR, Abrams P, Dmochowski R, Haab F, Nitti V, et al. Detrusor underactivity and the underactive bladder: a new clinical entity? A review of current terminology, definitions, epidemiology, aetiology, and diagnosis. Eur Urol. 2014;65(2):389-98. https://doi.org/10.1016/j.eururo.2013.10.015

Yunanto A, Rahardjo HE. Urodynamic profile in the Department of Urology, Cipto Mangunkusumo Hospital between 2010 and 2015. Med J Indones. 2019;28(2):146-53. https://doi.org/10.13181/mji.v28i2.1666

Soedarman S, Rahardjo HE. Comparison of voiding and filling phase abnormality post urodynamic with the clinical diagnosis in Cipto Mangunkusumo National Hospital. eJournal Kedokteran Indonesia. 2020;8(3):185-91. https://doi.org/10.23886/ejki.8.11956.

Johanes C, Wibisono E, Rahardjo HE. Urodynamics utility pattern among Indonesian urologist. Indonesian J Urol. 2016;23(1):30-4. https://doi.org/10.32421/juri.v23i1.201

Mohsin Rizvi R, Chughtai NG. Reliability of urodynamic interpretation in women presenting with urinary incontinence at a tertiary hospital. Urol Int. 2012;88(4):410-4. https://doi.org/10.1159/000334540

Wyndaele JJ, Gammie A, Bruschini H, De Wachter S, Fry CH, Jabr R, et al. Bladder compliance what does it represent: can we measure it, and is it clinically relevant? Neurourol Urodyn. 2011;30(5):714-22. https://doi.org/10.1002/nau.21129

Abrams P. Bladder outlet obstruction index, bladder contractility index and bladder voiding efficiency: three simple indices to define bladder voiding function. BJU Int. 1999;84(1):14-5. https://doi.org/10.1046/j.1464-410x.1999.00121.x

Osman NI, Chapple CR. Contemporary concepts in the aetiopathogenesis of detrusor underactivity. Nat Rev Urol. 2014;11(11):639-48. https://doi.org/10.1038/nrurol.2014.286

Yoshida M, Yamaguchi O. Detrusor underactivity: the current concept of the pathophysiology. Low Urin Tract Symptoms. 2014;6(3):131-7. https://doi.org/10.1111/luts.12070

Yu YD, Jeong SJ. Epidemiology of underactive bladder: common but underresearched. Investig Clin Urol. 2017;58(Suppl 2):S68-74. https://doi.org/10.4111/icu.2017.58.S2.S68

Yano M, Yasuda K, Kitahara S, Nakajima C, Iimura Y, Yamanishi T. The reason why prostatic hyperplasia causes lower urinary tract symptoms. Asian Med J. 2001;44:91-6.

Suskind AM, Smith PP. A new look at detrusor underactivity: impaired contractility versus afferent dysfunction. Curr Urol Rep. 2009;10(5):347-51. https://doi.org/10.1007/s11934-009-0055-2

Kooshesh M, Safdarian M, Nikfallah A, Vaccaro AR, Rahimi- Movaghar V. Association between detrusor muscle function and level of the spinal cord injury. Cent European J Urol. 2018;71(1):92-7. https://doi.org/10.5173/ceju.2017.1263

Kim TG, Yoo KH, Jeon SH, Lee HL, Chang SG. Effect of dominant hemispheric stroke on detrusor function in patients with lowerurinary tract symptoms. Int J Urol. 2010;17(7):656-60. https://doi.org/10.1111/j.1442-2042.2010.02547.x

Hill SR, Fayyad AM, Jones GR. Diabetes mellitus and female lower urinary tract symptoms: a review. Neurourol Urodyn. 2008;27(5):362-7. https://doi.org/10.1002/nau.20533

Chu FM, Dmochowski R. Pathophysiology of overactive bladder. Am J Med. 2006;119(3 Suppl 1):3-8. https://doi.org/10.1016/j.amjmed.2005.12.010

Wada N, Watanabe M, Ishikawa M, Takeuchi K, Miyauchi K, Abe N, et al. Uroflowmetry pattern in detrusor underactivity and bladder outlet obstruction in male patients with lower urinary tract symptoms. Low Urin Tract Symptoms. 2021;13(3):361-5. https://doi.org/10.1111/luts.12377

Published

2021-10-04

How to Cite

1.
Soedarman S, Rahardjo HE. Potential predictors of detrusor underactivity in a urology outpatient clinic: a 5-year single center experience study. Med J Indones [Internet]. 2021Oct.4 [cited 2024Dec.22];30(3):207-10. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/5102

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Section

Clinical Research
Abstract viewed = 853 times
PDF downloaded = 557 times HTML downloaded = 295 times EPUB downloaded = 245 times