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Factors determining the amount of residual urine in men with bladder outlet obstruction: Could it be a predictor for bladder contractility?

OBJECTIVE: To determine from urodynamic data what causes an increased postvoid residual urine volume (PVR) in men with bladder outlet obstruction (BOO), urethral resistance or bladder failure, and to determine how to predict bladder contractility from the PVR. PATIENTS AND METHODS: We analysed retro...

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Autores principales: Elmissiry, Mostafa M., Ali, Amr G., Abulfotooh, Ahmed, Moussa, Ahmed A., Ali, Gaber A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435510/
https://www.ncbi.nlm.nih.gov/pubmed/26019952
http://dx.doi.org/10.1016/j.aju.2014.03.003
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author Elmissiry, Mostafa M.
Ali, Amr G.
Abulfotooh, Ahmed
Moussa, Ahmed A.
Ali, Gaber A.
author_facet Elmissiry, Mostafa M.
Ali, Amr G.
Abulfotooh, Ahmed
Moussa, Ahmed A.
Ali, Gaber A.
author_sort Elmissiry, Mostafa M.
collection PubMed
description OBJECTIVE: To determine from urodynamic data what causes an increased postvoid residual urine volume (PVR) in men with bladder outlet obstruction (BOO), urethral resistance or bladder failure, and to determine how to predict bladder contractility from the PVR. PATIENTS AND METHODS: We analysed retrospectively the pressure-flow studies (PFS) of 90 men with BOO. Nine patients could not void and the remaining 81 were divided into three groups, i.e. A (30 men, PVR < 100 mL), B (30 men, PVR 100–450 mL) and C (21 men, PVR > 450 mL). The division was made according to a receiver operating characteristic curve, showing that using a threshold PVR of 450 mL had the best sensitivity and specificity for detecting the start of bladder failure. RESULTS: The filling phase showed an increase in bladder capacity with the increase in PVR and a significantly lower incidence of detrusor overactivity in group C. The voiding phase showed a significant decrease in voided volume and maximum urinary flow rate (Q(max)) as the PVR increased, while the urethral resistance factor (URF) increased from group A to B to C. The detrusor pressure at Q(max) (PdetQ(max)) and opening pressure were significantly higher in group B, which had the highest bladder contractility index (BCI) and longest duration of contraction. Group C had the lowest BCI and the lowest PdetQ(max). CONCLUSIONS: In men with BOO, PVR results from increasing outlet resistance at the start and up to a PVR of 450 mL, where the bladder reaches its maximum compensation. At volumes of >450 mL, both the outlet resistance and bladder failure are working together, leading to detrusor decompensation.
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spelling pubmed-44355102015-05-27 Factors determining the amount of residual urine in men with bladder outlet obstruction: Could it be a predictor for bladder contractility? Elmissiry, Mostafa M. Ali, Amr G. Abulfotooh, Ahmed Moussa, Ahmed A. Ali, Gaber A. Arab J Urol Voiding dysfunction/Female urology Original article OBJECTIVE: To determine from urodynamic data what causes an increased postvoid residual urine volume (PVR) in men with bladder outlet obstruction (BOO), urethral resistance or bladder failure, and to determine how to predict bladder contractility from the PVR. PATIENTS AND METHODS: We analysed retrospectively the pressure-flow studies (PFS) of 90 men with BOO. Nine patients could not void and the remaining 81 were divided into three groups, i.e. A (30 men, PVR < 100 mL), B (30 men, PVR 100–450 mL) and C (21 men, PVR > 450 mL). The division was made according to a receiver operating characteristic curve, showing that using a threshold PVR of 450 mL had the best sensitivity and specificity for detecting the start of bladder failure. RESULTS: The filling phase showed an increase in bladder capacity with the increase in PVR and a significantly lower incidence of detrusor overactivity in group C. The voiding phase showed a significant decrease in voided volume and maximum urinary flow rate (Q(max)) as the PVR increased, while the urethral resistance factor (URF) increased from group A to B to C. The detrusor pressure at Q(max) (PdetQ(max)) and opening pressure were significantly higher in group B, which had the highest bladder contractility index (BCI) and longest duration of contraction. Group C had the lowest BCI and the lowest PdetQ(max). CONCLUSIONS: In men with BOO, PVR results from increasing outlet resistance at the start and up to a PVR of 450 mL, where the bladder reaches its maximum compensation. At volumes of >450 mL, both the outlet resistance and bladder failure are working together, leading to detrusor decompensation. Elsevier 2014-09 2014-05-09 /pmc/articles/PMC4435510/ /pubmed/26019952 http://dx.doi.org/10.1016/j.aju.2014.03.003 Text en © 2014 Production and hosting by Elsevier B.V. on behalf of Arab Association of Urology. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).
spellingShingle Voiding dysfunction/Female urology Original article
Elmissiry, Mostafa M.
Ali, Amr G.
Abulfotooh, Ahmed
Moussa, Ahmed A.
Ali, Gaber A.
Factors determining the amount of residual urine in men with bladder outlet obstruction: Could it be a predictor for bladder contractility?
title Factors determining the amount of residual urine in men with bladder outlet obstruction: Could it be a predictor for bladder contractility?
title_full Factors determining the amount of residual urine in men with bladder outlet obstruction: Could it be a predictor for bladder contractility?
title_fullStr Factors determining the amount of residual urine in men with bladder outlet obstruction: Could it be a predictor for bladder contractility?
title_full_unstemmed Factors determining the amount of residual urine in men with bladder outlet obstruction: Could it be a predictor for bladder contractility?
title_short Factors determining the amount of residual urine in men with bladder outlet obstruction: Could it be a predictor for bladder contractility?
title_sort factors determining the amount of residual urine in men with bladder outlet obstruction: could it be a predictor for bladder contractility?
topic Voiding dysfunction/Female urology Original article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4435510/
https://www.ncbi.nlm.nih.gov/pubmed/26019952
http://dx.doi.org/10.1016/j.aju.2014.03.003
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