Moderated Poster

Poster, Podium & Video Sessions

MP31-15: A new approach to measuring detrusor contraction pattern change after radical prostatectomy

Saturday, May 13
9:30 AM - 11:30 AM
Location: BCEC: Room 156

Presentation Authors: Takeya Kitta*, Yukiko Kanno, Mifuka Ouchi, Kimihiko Moriya, Satoru Maruyama, Takashige Abe, Nobuo Shinohara, Sarporo, Japan

Introduction: Pressure flow studies (PFS) have been regarded as the gold standard for evaluating bladder function. We previously reported that radical prostatectomy (RP) restore the detrusor contractility of prostate cancer patients. However, precise changes of detrusor contraction pattern remain to be completely elucidated. The most widely used measurement of bladder contractility is the Watts factor (WF). WF was calculated throughout bladder emptying and plotted as a function of the volume of liquid in the bladder at each moment in time. Impaired bladder contraction represent not only decreased the peak of WF, but also poorly sustained contractions. From this point of view, the maximum height of the resulting curve (Wmax) and its pattern should be discussed separately. In the present study, we focused on the detrusor contraction pattern using pressure flow study parameters.

Methods: In the present study, we calculated the percentage of when reach the peak of WF (Wmax%) and Area under the curve of throughout the voiding cycle (WF-AUC) (figure). WF curves allow detrusor contraction power to be visualized throughout the entire duration of micturition. Wmax% and WF-AUC could represent the pattern of detrusor contractility.
Thirty seven patients with clinically localized prostate cancer who were urodynamically evaluated pre and post RP. The urodynamic parameters included the maximum flow rate (Qmax), postvoid residual volume (PVR), Wmax, Wmax% and WF-AUC were examined.


Results: Qmax increased significantly after RP (13.0&[rarr]17.3 ml/min, P<0.01). PVR significantly decreased (49.6&[rarr]31.4 ml, P<0.05). Although Wmax did not changed significantly (10.5&[rarr]11.0 W/m2), Wmax% and WF-AUC was increased significantly (51.6&[rarr]80.1, P<0.01 and 7714.0&[rarr]12115.8, P<0.05). Wmax is a measure of detrusor contraction strength at a single point in time, whereas Wmax% and WF-AUC can confirm the improvement of detrusor contraction throughout micturition to assess overall detrusor contractility.

Conclusions: Our study confirmed that RP change the detrusor contractility pattern of prostate cancer patients. The measurement of Wmax% and WF-AUC provides new approach to the bladder contraction sustainability.

Source Of Funding: none

Takeya Kitta

Hokkaidi University

Name: Takeya Kitta, MD, PhD

EDUCATION
Hokkaido University School of Medicine, April 1992-March 1994
Premedical Program, Sapporo, Japan

Hokkaido University School of Medicine, April 1994-March 1998
Sapporo, Japan

Work History
Medical residency
Hokkaido University Medical Hospital, Urology May 1998- March 2004
Sapporo, Japan

Clinical fellow
Hokkaido University Medical Hospital, Urology April 2004- March 2005
Sapporo, Japan

Assistant Professor
Hokkaido University Medical Hospital, Urology April 2012- September 2015
Sapporo, Japan

Lecturer
Hokkaido University Medical Hospital, Urology October 2015-
Sapporo, Japan

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MP31-15: A new approach to measuring detrusor contraction pattern change after radical prostatectomy



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