scholarly journals Identifying occult bladder outlet obstruction in women with detrusor-underactivity-like urodynamic profiles

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Po-Ming Chow ◽  
Sheng-Mou Hsiao ◽  
Hann-Chorng Kuo
Keyword(s):  
Bladder Outlet Obstruction ◽  
Operating Characteristic ◽  
Voiding Dysfunction ◽  
Outlet Obstruction ◽  
Low Flow ◽  
Detrusor Underactivity ◽  
Key Factors ◽  
Radiographic Evidence ◽  
Voided Volume ◽  
Lower Flow Rate

AbstractVoiding dysfunction can result from detrusor underactivity (DU), bladder outlet obstruction (BOO), or both. Conceptually, women with high-pressure low-flow urodynamic profiles are diagnosed with BOO without DU. However, the possibility of BOO is often neglected in women with DU-like (low-pressure low-flow) urodynamic (UDS) profiles. By reviewing the videourodynamic studies (VUDS) of 1678 women, our study identified the key factors suggesting urodynamic BOO (determined by radiographic evidence of obstruction) in women with DU-like UDS profiles (Pdet.Qmax < 20 cmH2O and Qmax < 15 mL/s). In 355 women with DU-like UDS profiles, there were 70 (19.7%) with BOO and 285 (80.3%) without BOO. The BOO group had predominantly obstructive symptoms. The BOO group showed significantly decreased bladder sensation, lower detrusor pressure (Pdet.Qmax), lower flow rate (Qmax), smaller voided volume, and larger post-voiding residual (PVR) compared to the non-BOO group. In multivariate analysis, volume at first sensation, Qmax, PVR, and detrusor overactivity (DO) remained independent factors for BOO. The receiver operating characteristic (ROC) areas for the parameters were largest for PVR (area = 0.786) and Qmax (area = 0.742). The best cut-off points were 220 mL for PVR and 4 mL/s for Qmax. Our findings provide simple indicators for BOO in women with DU.

scholarly journals Potential urine biomarkers in bladder outlet obstruction-related detrusor underactivity

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Hann-Chorng Kuo ◽  
Yuan-Hong Jiang ◽  
Jia-Fong Jhang ◽  
Yung-Hsiang Hsu ◽  
Han-Chen Ho
Keyword(s):  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Detrusor Underactivity ◽  
Urine Biomarkers

URINE FLOW DYNAMICS THROUGH THE URETHRA IN PATIENTS WITH BLADDER OUTLET OBSTRUCTION

2014 ◽  
Vol 14 (04) ◽  
pp. 1450052 ◽  
Author(s):  
TAKURO ISHII ◽  
YUKIO NAYA ◽  
TOMONORI YAMANISHI ◽  
TATSUO IGARASHI
Keyword(s):  
Fluid Dynamics ◽  
Energy Loss ◽  
Bladder Outlet Obstruction ◽  
Voiding Dysfunction ◽  
Pressure Sensors ◽  
Outlet Obstruction ◽  
Fluid Simulation ◽  
Flow Dynamics ◽  
Dynamics Simulation ◽  
Common Disease

Voiding dysfunction is a common disease among the elderly male population. However, few studies have elucidated the flow dynamics of the disease mechanism. We attempted to clarify the fluid dynamics of urine in the prostatic urethra (PU) in patients with bladder outlet obstruction (BOO), a common disease associated with voiding dysfunction. A model of normal PU and three phase models following the BOO progression were prepared using 3D CAD software tracing cystourethroscopic images. In fluid dynamics computation, the normal detrusor pressure was applied to the bladder side in each model. Results of fluid simulation were compared for flow trajectory line, fluid energy dynamics using Bernoulli's principle and pressure loss coefficient. In the BOO model, a large vortex was observed adjacent to the bladder outlet (BO) with increased hydraulic energy loss during the passage through the tract. In contrast, opening of the BO eliminated the vortex with reduction of hydraulic energy loss. These results corresponded with clinical data measured by catheterized pressure sensors inserted into the urethra, and those of urethral diameter measured by urethrography. Fluid dynamics simulation using CAD models can clarify the mechanism of voiding dysfunction in a less invasive and more acceptable way in patients with BOO.

scholarly journals Recent advances in the understanding and management of underactive bladder

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 437 ◽  
Author(s):  
Su-Min Lee ◽  
Hashim Hashim
Keyword(s):  
Bladder Outlet Obstruction ◽  
Lower Urinary Tract ◽  
Contemporary Literature ◽  
Outlet Obstruction ◽  
Detrusor Underactivity ◽  
Underactive Bladder ◽  
Recent Advances ◽  
Urinary Tract Symptoms ◽  
Wide Range ◽  
Lower Urinary

Underactive bladder (UAB) is an important and complex urological condition resulting from the urodynamic finding of detrusor underactivity. It can manifest in a wide range of lower urinary tract symptoms, from voiding to storage complaints, and can overlap with other conditions, including overactive bladder and bladder outlet obstruction. However, UAB continues to be poorly understood and inadequately researched. In this article, we review the contemporary literature pertaining to recent advances in defining, understanding, and managing UAB.

scholarly journals Transurethral Incision of the Bladder Neck in a Woman with Primary Bladder Neck Obstruction after Kidney Transplantation

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Dean Markić ◽  
Maksim Valenčić ◽  
Anton Maričić ◽  
Kristian Krpina ◽  
Dražen Rahelić ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Bladder Neck ◽  
Bladder Outlet Obstruction ◽  
Voiding Dysfunction ◽  
Outlet Obstruction ◽  
Postvoid Residual Urine ◽  
Bladder Neck Obstruction ◽  
Primary Bladder ◽  
Primary Bladder Neck Obstruction ◽  
Transurethral Incision

Voiding dysfunction is frequently seen in the early posttransplant period. Among other causes, this condition can arise due to bladder outlet obstruction. Primary bladder neck obstruction (PBNO) is a possible but very rare cause of bladder outlet obstruction. We present the case of a 52-year-old woman who, after kidney transplantation, presented with PBNO. The diagnosis was established based on symptoms, uroflowmetry, and multichannel urodynamics with electromyography. The transurethral incision of the bladder neck was made at the 5- and 7-o’clock position. After the operation, the maximal flow rate was significantly increased, and postvoid residual urine was decreased compared to the preoperative findings. The patient was followed for 5 years, and her voiding improvement is persistent. This is the first reported case of PBNO treated with a transurethral incision of the bladder neck in a posttransplantation female patient.

Signs and symptoms that distinguish detrusor underactivity from mixed detrusor underactivity and bladder outlet obstruction in male patients

2018 ◽  
Vol 37 (4) ◽  
pp. 1501-1505 ◽  
Author(s):  
Andrew Gammie ◽  
Mathilde Kaper ◽  
Achim Steup ◽  
Satoshi Yoshida ◽  
Caroline Dorrepaal ◽  
...  
Keyword(s):  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Signs And Symptoms ◽  
Detrusor Underactivity ◽  
Male Patients
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