Obstructive uropathy induced bladder dysfunction can be reversible: bladder compliance measures before and after treatment.
OBJECTIVE
We demonstrated that abnormal bladder compliance in the setting of obstructive uropathy can be improved by relief of bladder outlet obstruction.


METHODS
A cohort of 9 men with nonneurogenic lower urinary tract symptoms and videourodynamics proven bladder outlet obstruction were identified prospectively from a university urology practice. Study exclusion criteria ensured absence of active urinary infection, hematuria and neurourological pathology. Testing specifically focused on assessment of the bladder compliance curve, and a compliance value was calculated (ml./cm. H2O). Treatment intervention consisted of transurethral incisions or resection of the prostate in 8 cases and transurethral balloon dilation of a urethral stricture in 1. Followup videourodynamics testing was performed 1 month after treatment to confirm relief of outlet obstruction and reassess bladder compliance.


RESULTS
Mean patient age was 75.2 +/- 6.16 years. Pretreatment mean bladder compliance +/- SE was 3.06 +/- 0.45 ml./cm. H2O. At 1 month after treatment videourodynamics testing confirmed relief of obstruction in the cohort. Posttreatment mean bladder compliance +/- SE was 13.53 +/- 0.45 ml./cm. H2O. Nonparametric paired t test analysis determined that the difference between pretreatment and posttreatment bladder compliance was statistically significant at p = 0.0117.


CONCLUSIONS
This pilot study suggests that relief of obstructive uropathy even in elderly patients with long-standing lower urinary tract symptoms, can significantly improve bladder compliance.
Leng
Wendy W
WW
Department of Urology, University of California San Francisco, San Francisco, California, USA.
McGuire
Edward J
EJ
D000368:Aged; D000369:Aged, 80 and over; D003187:Compliance; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000503:physiopathology; D001748:Urinary Bladder Neck Obstruction / Q000150:complications* / Q000628:therapy*