Overactive bladder: urodynamic characteristics of detrusor overactivity due to the etiology of low urinary tract dysfunction


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Abstract

The aim of the study was to detect features of detrusor overactivity as an urodynamic phenomenon in patients with different etiology of low urinary tract dysfunction. Materials and methods. The study included 283 patients (61% females and 39% males) aged 18-82 years (49.2+13.5) with neurogenic overactive bladder (n=197), idiopathic overactive bladder (n=41), radiation cystitis (n=8) and chronic pelvic pain (n=37). All patients underwent an urodynamic study (UDS) in Sverdlovsk Regional Clinical Hospital in the period from 2017 to 2020. Results. Detrusor overactivity was detected by UDS in 63.4% patients with idiopathic, 94.2% with neurogenic overactive bladder (OAB) and 2.7% in patients with pelvic pain. Maximal amplitude of detrusor pressure during involuntary bladder contraction was significantly higher in neurogenic dysfunction than in idiopathic (25.76+26.21 cm Н2О and 10.1+3.4 cm Н2О respectively, p=0.003). According to the ROC-analysis, detrusor pressure amplitude has a high predictor value in the diagnosis of a neurogenic origin of overactive bladder (AUC=0.863, p=0.045). The sensitivity of pressure more than 9.5 cm Н20 was 88%. Bladder volume at the time of first involuntary contraction was 137+120 ml and 218+120 ml (p=0.07) for neurogenic and idiopathic OAB respectively. Neurogenic detrusor overactivity followed by urgency incontinence more often than idiopathic (59.5% vs 19.2%). Conclusion. Neurogenic detrusor overactivity is characterized by larger amplitude and higher rate of urgency incontinence.

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About the authors

E. S Philippova

Ural State Medical University; Sverdlovsk Regional Clinical Hospital №1

Email: filippova.cat@yandex.ru
PhD, Associate professor at the Urological Department; urologist

I. V Bazhenov

Ural State Medical University; Sverdlovsk Regional Clinical Hospital №1

Email: biv@okb1.ru
Dr. Sc., Professor of Medicine, Professor at the Urological Department

A. V Ziryanov

Ural State Medical University; Sverdlovsk Regional Clinical Hospital №1

Email: zav1965@mail.ru
Dr. Sc., Professor, Head of the Urological Department

V. N Zhuravlev

Ural State Medical University

Email: zhuravlev@okb1.ru
Dr. Sc., Profesor of Medicine, Professor at the Urological Department

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