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Original Research

Med Arch. 2012; 66(3): 185-189


The Significance of the Influence of Aging and Infravesical Obstruction Caused by Benign Prostatic Enlargement on Detrusor Impairment

Damir Aganovic, Osman Hadziosmanovic, Alden Prcic, Benjamin Kulovac.




Abstract

Objective: to analyze the influence of aging and infravesical obstruction on cystometric characteristics of patients with lower urinary tract symptoms (LUTS) and proven benign prostatic enlargement (BPE). Methodology: A retrospective analysis was performed of basic characteristics of randomly chosen 213 patients with LUTS caused by BPE and urodynamic findings made in period 2005-2009 at the Urology Department of the Sarajevo University Clinical Center. The patients were divided into groups based on their age (70 years /72 pat.), and the degree of bladder compliance loss (40 ml/cmH2O-80 pat.). All patients had International Prostate Symptom Score (IPS-S) completed, prostate volume measured transabdominally, free uroflowmetry, as well as complete urodynamic study (UDS) findings – cystometry and pressure/flow studies (PFS). The PFS data were plotted on L-PURR, URA and ICS nomogram, bladder contractility index (BCI) and obstruction coefficient (OCO) were calculated for each patient. Results: There was no statistically significant difference of IPS-S, prostate volume and postvoid residual urine among the age groups. Qmax (ml/sec.) declines significantly with age (mean 11.9 vs. 10.3 vs. 7.9, ANOVA p< 0.001), along with statistically significant decrease of cystometric capacity (mean 331ml vs. 293 ml vs. 264 ml, p=0.001), bladder compliance (BC-ml/cmH2O) (mean 35.3 vs. 31 vs. 26.5, p=0.013), with increased incidence of detrusor overactivity (DO) (21.7% vs. 32.6% vs. 45.8%, chi2 test for trend p=0.006), followed by a higher incidence of obstruction (URA≥29 cmH2O) (37% patients vs. 61% patients vs. 72.2% patients Chi2 for trend=13.8; p=0.0002), along with noticeable reduction of BCI (117 vs. 121 vs. 106; p=0.02). Patients with severe BC damage (

Key words: BPE, UDS, infravesical obstruction, cystometric characteristics.






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