Detrusor after-contraction on ambulatory urodynamics in symptomatic women

Int J Urol. 2015 Nov;22(11):1058-62. doi: 10.1111/iju.12887. Epub 2015 Aug 24.

Abstract

Objectives: To investigate the association between detrusor after-contraction and urodynamic parameters in a cohort of patients undergoing urodynamic studies by ambulatory monitoring.

Methods: All symptomatic adult female patients with non-neurogenic lower urinary tract dysfunction having ambulatory monitoring over the period January 1998 to January 2014 were included. Urodynamic traces were reviewed to identify detrusor after-contraction. Measured urodynamic variables were Qmax (mL/s), V(void) (mL) and P(det.Qmax) (cmH(2)O). Student's unpaired t-test was used to compare the mean of the variable in the detrusor after-contraction and non-detrusor after-contraction groups.

Results: We identified 331 women with a median age of 50 years (range 16-82). Detrusor after-contraction was seen after at least one void in 122 patients giving a prevalence of 37%. A total of 167 (51%) patients had detrusor overactivity. Diagnosis of detrusor overactivity was associated with the presence of detrusor after-contraction (P < 0.05). Overall, patients with detrusor after-contraction had a statistically higher mean P(det.Qmax) (32 vs 28 cmH(2)O, P = 0.04) and lower mean voided volume (300 vs 378 mL, P < 0.001).

Conclusion: These findings suggest a relatively high prevalence of detrusor after-contraction during ambulatory monitoring, and an association between detrusor overactivity, V(void), P(det.Qmax) and detrusor after-contraction recorded during ambulatory monitoring. Therefore, a link between detrusor after-contractions and the syndrome of overactive bladder can be postulated.

Keywords: after-contraction; ambulatory urodynamics; detrusor; overactive bladder syndrome.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Humans
  • Middle Aged
  • Monitoring, Ambulatory
  • Urinary Bladder / physiopathology*
  • Urinary Bladder, Overactive / epidemiology*
  • Urinary Bladder, Overactive / physiopathology*
  • Urination
  • Urodynamics*
  • Young Adult