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KMID : 0358320120530050342
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Korean Journal of Urology
2012 Volume.53 No. 5 p.342 ~ p.348
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Prevalence and Clinical Features of Detrusor Underactivity among Elderly with Lower Urinary Tract Symptoms: A Comparison between Men and Women
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Jeong Seong-Jin
Kim Hyeon-June
Lee Young-Ju
Lee Jeong-Keun
Lee Byung-Ki
Choo Young-Min
Oh Jong-Jin
Lee Sang-Cheol
Jeong Chang-Wook
Yoon Cheol-Yong
Hong Sung-Kyu
Byun Seok-Soo
Lee Sang-Eun
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Abstract
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Purpose: To identify the prevalence and clinical features of detrusor underactivity (DU) in elderly men and women presenting with lower urinary tract symptoms (LUTS).
Materials and Methods: We reviewed 1,179 patients aged over 65 years who had undergone a urodynamic study for LUTS with no neurological or anatomical conditions. DU was defined as a bladder contractility index <100 and a maximal flow rate (Qmax) ≤12 ml/s combined with a detrusor pressure at Qmax ≤10 cmH2O for men and women, respectively.
Results: Of the patients, 40.2% of men and 13.3% of women were classified as having DU (p<0.001). Types of clinical symptoms were not significantly different between patients with and without DU. In men, whereas the prevalence of bladder outlet obstruction (BOO) was constant across the age spectrum, the prevalence of DU and detrusor overactivity (DO) increased with age, and 46.5% of men with DU also had DO or BOO. In women, the prevalence of DU also increased with age, and the trend was more remarkable in women aged over 70 years. DU was accompanied by DO or urodynamic stress urinary incontinence (USUI) in 72.6% of the women with DU. Women with DU were found to have lower cystometric capacity and exhibited a greater incidence of reduced compliance than did women without DU.
Conclusions: DU was a common mechanism underlying LUTS in the elderly population, especially in men. One half of the men and three quarters of the women with DU also had other pathologies such as DO, BOO, or USUI.
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KEYWORD
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Aged, Prevalence, Urinary bladder, Urination disorders, Urodynamics
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