title: [Differences of urodynamic tests between patients of detrusor hyperactivity with impaired contractility with and without bladder outlet obstruction and effect of anticholinergic medications in these patients].
abstract: OBJECTIVE
  To explore the differences of urodynamic parameters and lower urinary symptoms between detrusor hyperactivity with impaired contractility (DHIC) patients and DHIC patients with bladder outlet obstruction (BOO) and evaluate the effects and risks of anticholinergic medications in these patients.
  
  
  METHODS
  A retrospective analysis was performed in 56 DHIC patients at our hospital between February 2000 to February 2011. Among them, 19 patients were complicated with BOO. Urodynamic studies were conducted and lower urinary symptoms assessed in all patients. Then the urodynamic parameters and lower urinary symptoms scores were compared between the DHIC and DHIC plus BOO patients. Among them, 27 received anticholinergic medications and there were 11 BOO patients. After 2-month anticholinergic medications, the differences of lower urinary symptom score were analyzed and anticholinergic-induced retention was also investigated.
  
  
  RESULTS
  As compared with the DHIC patients, the DHIC plus BOO patients had a higher post-voiding residual urine (70 (23 - 106) vs 20 (10 - 81) ml, P = 0.02), higher total international prognostic scoring system (IPSS) score (25.6 ± 3.9 vs 22.1 ± 4.1, P = 0.00) and higher total voiding symptom score (15.3 ± 2.9 vs 11.8 ± 3.3, P = 0.00). After 2-month anticholinergic medications, the IPSS score of DHIC plus BOO patients decreased from 25.7 ± 4.6 to 23.6 ± 4.9 (P = 0.01), 2/11 patients developed urinary retention. The IPSS scores of DHIC patients decreased from 22.8 ± 4.7 to 21.4 ± 4.6 (P = 0.01) and none had urinary retention.
  
  
  CONCLUSIONS
  The DHIC plus BOO patients have more aggravated bladder empting and more severe lower urinary symptoms especially during voiding phase. Anticholinergic medications may alleviate the lower urinary symptoms in DHIC and DHIC plus BOO patients. But anticholinergic-induced retention is common among the DHIC plus BOO patients.
authors.affiliation: Department of Urology, Beijing Jishuitan Hospital, Beijing, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
authors.forename: Feng
authors.initials: F
authors.lastname: He
authors.forename: Li-bo
authors.initials: LB
authors.lastname: Man
authors.forename: Guang-lin
authors.initials: GL
authors.lastname: Huang
authors.forename: Hai-dong
authors.initials: HD
authors.lastname: Wang
authors.forename: Hai
authors.initials: H
authors.lastname: Wang
authors.forename: Gui-zhong
authors.initials: GZ
authors.lastname: Li
authors.forename: Jian-wei
authors.initials: JW
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction; D012189:Retrospective Studies; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D053201:Urinary Bladder, Overactive / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D014563:Urodynamics; D055815:Young Adult
chemical_list: D018680:Cholinergic Antagonists