Investigation of the relationship between bladder function and sarcopenia using pressure flow studies in elderly male patients

Neurourol Urodyn. 2019 Jun;38(5):1417-1422. doi: 10.1002/nau.24001. Epub 2019 Apr 15.

Abstract

Aims: Although detrusor underactivity is often encountered in elderly patients, the etiology remains unclear. We have hypothesized that sarcopenia was associated with impaired bladder contractility. Therefore, we have evaluated the relationship between bladder contractility and clinical parameters including sarcopenia markers in elderly male patients.

Methods: This retrospective, single-centre study included male patients over 65 years of age who underwent a pressure flow study (PFS). We excluded patients with any previous medical histories that could affect bladder function, currently on urinary medication, and with no available data of abdominal CT scan. The psoas muscle area (PMA) (cm2 /m2 ) was measured as a surrogate for psoas muscle mass on computed tomography. PMA, serum CRP, and albumin are known as sarcopenia markers. Correlation and multiple regression analyses were performed to evaluate the association of bladder contractility index (BCI) with the following parameters: age, body mass index (BMI), prostate volume, bladder outlet obstruction index (BOOI), serum C-reactive protein (CRP), serum albumin, and PMA.

Results: Out of 558 male patients identified in our PFS database, 119 patients were enrolled. In the correlation analysis, age, prostate volume, serum albumin, BOOI, and PMA significantly correlated with BCI. However, no significant correlation of BCI with CRP or BMI was observed. Multiple linear regression analysis showed that serum albumin, BOOI, and PMA were significantly associated with BCI.

Conclusions: We have demonstrated that serum albumin and PMA were significantly positively associated with detrusor contractility. It is possible that sarcopenia is associated with impaired detrusor contractility.

Keywords: detrusor underactivity; sarcopenia; urodynamics.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diagnostic Techniques, Urological
  • Humans
  • Male
  • Muscle Contraction / physiology
  • Retrospective Studies
  • Sarcopenia / complications
  • Sarcopenia / physiopathology*
  • Urinary Bladder / physiopathology*
  • Urinary Bladder, Underactive / etiology
  • Urinary Bladder, Underactive / physiopathology*
  • Urodynamics / physiology*