Presentation Authors: Elodi Dielubanza*, Elise De, Boston, MA, Tamara Bavendam, Bethesda, MD, Wesley Wang, Boston, MA, Michael Maurao, Rebekah Zincavage, Watertown, MA, Michael O'Leary, Boston, MA, Raymond Rosen, Watertown, MA
Introduction: Underactive bladder syndrome (UAB) is a symptom complex, which remains an inadequately characterized clinical entity from an etiological and clinical standpoint. To facilitate further study in this area, we have implemented a protocol to develop and validate a patient reported outcome measure for UAB, using a cohort of patients with detrusor underactivity. We present clinical and urodynamic characteristics of our underactive bladder patient cohort.
Methods: Patients â‰¥ age 45 undergoing urodynamic testing at Brigham and Women&[prime]s Hospital and Massachusetts General Hospital were screened for detrusor underactivity (DU). Urodynamic Inclusion criteria were bladder contractility index (BCI) < 100 and bladder outlet obstruction index (BOOI) < 20 in men and maximum flow rate (Qmax) of < 15ml/s and detrusor pressure at maximum flow rate (PdetQmax) < 20cmH20 in women. Those with major neurologic disease or using medications that alter sensorium or detrusor muscle function in the prior year were excluded. Eligible patients were recruited for voluntary participation in the study. Clinical and urodynamic data were recorded.
Results: The most common presenting symptoms in women were incontinence (50%), difficulty initiating or maintaining urine stream (35%), and urgency and frequency (28.5%). Stress type was the most common incontinence. Men reported urinary urgency and frequency (44%), difficulty initiating or maintaining stream (39.6%) and incontinence (17.4%). Stress and Urgency incontinence were equal. Mean bladder capacity was within the normal range (i.e 300-500mL) for both genders. Bladder capacity < 300ml occurred in 25% of men and 21% of women and >600ml occurred in 14% of each group, respectively. The majority of the cohort had a very slow urine flow rate, Qmax < 10ml/s in 60% of women and 63% of men. Incomplete emptying was common, post-void residual urine volume (PVR) was â‰¥ 50% of bladder capacity in 36.5% of men and 48.8% of women.
Conclusions: Although the urodynamic findings in our underactive bladder syndrome cohort reflect a &[Prime]failure to empty&[Prime], the patient experience can often reflect a subjective &[Prime]failure to store&[Prime]. This underscores the challenge encountered in the identification and management of patients with underactive bladder and the need for further study in this area.
Source of Funding: NIH Grant: 1U01DK110377