Prevalence and Clinical Features of Detrusor Underactivity among Elderly with Lower Urinary Tract Symptoms: A Comparison between Men and Women.
OBJECTIVE
To identify the prevalence and clinical features of detrusor underactivity (DU) in elderly men and women presenting with lower urinary tract symptoms (LUTS).


METHODS
We reviewed 1,179 patients aged over 65 years who had undergone a urodynamic study for LUTS with no neurological or anatomical conditions. DU was defined as a bladder contractility index <100 and a maximal flow rate (Qmax) ≤12 ml/s combined with a detrusor pressure at Qmax ≤10 cmH(2)O for men and women, respectively.


RESULTS
Of the patients, 40.2% of men and 13.3% of women were classified as having DU (p<0.001). Types of clinical symptoms were not significantly different between patients with and without DU. In men, whereas the prevalence of bladder outlet obstruction (BOO) was constant across the age spectrum, the prevalence of DU and detrusor overactivity (DO) increased with age, and 46.5% of men with DU also had DO or BOO. In women, the prevalence of DU also increased with age, and the trend was more remarkable in women aged over 70 years. DU was accompanied by DO or urodynamic stress urinary incontinence (USUI) in 72.6% of the women with DU. Women with DU were found to have lower cystometric capacity and exhibited a greater incidence of reduced compliance than did women without DU.


CONCLUSIONS
DU was a common mechanism underlying LUTS in the elderly population, especially in men. One half of the men and three quarters of the women with DU also had other pathologies such as DO, BOO, or USUI.
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Seong Jin
SJ
Jeong
Hyeon June
HJ
Kim
Young Ju
YJ
Lee
Jeong Keun
JK
Lee
Byung Ki
BK
Lee
Young Min
YM
Choo
Jong Jin
JJ
Oh
Sang Cheol
SC
Lee
Chang Wook
CW
Jeong
Cheol Yong
CY
Yoon
Sung Kyu
SK
Hong
Seok-Soo
SS
Byun
Sang Eun
SE
Lee