Idiopathic voiding dysfunction: a urodynamic basis of differential diagnosis
Kuo, H.C.; Tsai, T.C.
Journal of the Formosan Medical Association 87(11): 1055-1064
1988
ISSN/ISBN: 0371-7682 PMID: 3235965 Document Number: 322270
One hundred and fifty-three patients suffering from dysuria and other voiding difficulties were evaluated by urodynamic studies. None of them had organic bladder outlet obstruction or frank neuropathies. Five patients (3%) were proven to have normal traces either in the uroflowmetry or cystometric findings. Twenty-one patients (14%) had a hypersensitive bladder and 10 (6%) had detrusor instability. In 67 patients (44%) a poorly relaxed external sphincter was noted to accompany a normal or poorly contractile bladder. Fifty patients (33%) were found to have a poor detrusor contractility which was caused by a poor compliant bladder in 16, low detrusor contractility in 19 and hypotonic bladder in 15. The symptomatology in these patients was similar. Urodynamic study plays an important role in identifying the different detrusor and urethral activities in patients with idiopathic voiding dysfunctions and will facilitate proper management according to the various urodynamic features. The treatment results were successful in 74% of patients with hypersensitive bladders or detrusor instability and in 40% of patients with a poorly relaxed external sphincter. Patients with poor detrusor contractility were also managed by urinary diversion or intermittent catheterization to prevent further deterioration of the upper urinary tract.