Assessment of the poorly contractile or acontractile bladder in the older male in the absence of neuropathy.
Up to 30% of patients who undergo prostatectomy are left with residual symptoms. Most have persistent detrusor instability, but some have poorly contractile or acontractile bladders. Over a 2-year period, 42 neurologically normal patients were shown to have a hypocontractile or acontractile bladder on urodynamic testing; 27 had undergone outflow tract surgery. Four patients who were totally incontinent had undergone at least 2 transurethral resections. The remainder had severe frequency, urgency and nocturia. Urodynamically, all but 7 patients with poor compliance had normal filling cystometrograms, all but 8 had residual urine volumes less than 100 ml, and 26 had less than 5 ml. Thus their symptoms are difficult to explain. Apart from the insertion of an artificial sphincter in those with total incontinence, treatment did not improve any of these patients.
McInerney
P D
PD
Department of Urology, Royal Infirmary, Cardiff.
Robinson
L Q
LQ
Weston
P M
PM
Cox
R
R
Stephenson
T P
TP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D001743:Urinary Bladder / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000503:physiopathology* / Q000628:therapy; D014563:Urodynamics