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Assessment of the Poorly Contractile or Acontractile Bladder in the Older Male in the Absence of Neuropathy
Author(s) -
McINERNEY P. D.,
ROBINSON L. Q.,
WESTON P. M. T.,
COX R.,
STEPHENSON T. P.
Publication year - 1990
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1990.tb14689.x
Subject(s) - medicine , nocturia , sphincter , detrusor instability , urology , surgery , residual urine , prostatectomy , urodynamic testing , urinary system , urinary incontinence , prostate , cancer
Summary— Up to 30% of patients who undergo prostatectomy are left with residual symptoms. Most have persistent detrusor instability, but some have poorly contractile or acontractile bladders. Over a 2‐year period, 42 neurologically normal patients were shown to have a hypocontractile or acontractile bladder on urodynamic testing; 27 had undergone outflow tract surgery. Four patients who were totally incontinent had undergone at least 2 transurethral resections. The remainder had severe frequency, urgency and nocturia. Urodynamically, all but 7 patients with poor compliance had normal filling cystometrograms, all but 8 had residual urine volumes less than 100 ml, and 26 had less than 5 ml. Thus their symptoms are difficult to explain. Apart from the insertion of an artificial sphincter in those with total incontinence, treatment did not improve any of these patients.