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MP63-14: Overnight ambulatory urodynamics findings in patients with nocturia and/or nocturnal enuresis

Sunday, May 14
3:30 PM - 5:30 PM
Location: BCEC: Room 153

Presentation Authors: Eskinder Solomon, Megan Duffy, Sachin Malde, Hazel Ecclestone*, Mahreen Paksad, Rizwan Hamid, Tamsin Greenwell, Jeremy Ockrim, London, United Kingdom

Introduction: Nocturnal symptoms are very troublesome to patients, yet objective methods to assess night time bladder function are limited. We aimed to determine the prevalence of detrusor overactivity in patients with nocturia and nocturnal enuresis during overnight ambulatory urodynamics

Methods: Twenty patients whose most bothersome symptoms were nocturia and/or nocturnal enuresis underwent overnight ambulatory urodynamic studies. All patients had undergone prior undiagnostic standard filling cystometry. Traces were reviewed and it was documented if detrusor overactivity (DO) +/-leakage was demonstrated, as well as the maximum voided volume and nocturnal urine output.

Results: The mean ( SD) agewas 45.1 ± 19.9 years, comprising 14 female and 6 male patients All patients presented with nocturia with 17 patients additionally complaining of nocturnal enuresis. Only 5 patients reported bothersome day time symptoms. The mean duration for the overnight ambulatory urodynamic studies was 14.5 hours (range 12 to 16.6 hours). DO was demonstrated in 80% (n=16) of patients. 15 out of the 17 (88.3%) patients with nocturnal enuresis demonstrated DO. Small volume SUI was demonstrated in 4 out the 17 (23.5%) patients with nocturnal enuresis. The mean and median peak DO pressure was 68.3 (± 50.9) and 50 cmH2O. There appears to be no significant difference in the maximum voided volume and nocturnal urine output between the two DO groups (NB: small sample DO -ve patients). Incontinence was observed in 15 out of 16 (93%) patients with DO.

Conclusions: 80.0% of patients who present with nocturia and 88% with nocturnal enuresis demonstrate detrusor overactivity on overnight ambulatory urodynamics tests. The DO pressures demonstrated were large amplitude and resulted in incontinence by overcoming in most cases an otherwise competent outlet. Nocturnal ambulatory urodynamics are a useful clinical adjunct for assessing night time urinary symptoms.

Source Of Funding: None

Tamsin J. Greenwell, MB ChB, MD, FRCS (Urol)

University College London Hospital

Tamsin Greenwell has been a Consultant Urological Surgeon with Special Interest in Female, Functional and Restorative Urology ay University College London Hospitals, London UK since 2002. Her particular interests are; vesico-vaginal fistula, urethral diverticulum, male and female urethral and ureteric stricture, male and female recurrent urinary incontinence. She has an extensive interest in surgical education and was Postgradate Tutor for Urology for University College London from 2002-2008, the Royal College Surgeons of England Urology Tutor from 2006-2011 and British Association of Urological Surgeons Director of Education from 2011-2013. She runs the internationnally acclaimed Female Urology and Urogynaecology Masterclass at University College London Hospital anually in November each year with live surgical demonstrations. She is currently chair of the Functional Neur-Urology and Urodynamics section of the British Association of Urological Surgeons.

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MP63-14: Overnight ambulatory urodynamics findings in patients with nocturia and/or nocturnal enuresis



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