Detrusor contractility and overactive bladder in patients with cerebrovascular accident

A retrospective analysis of urodynamic studies was conducted to investigate detrusor contractility following cerebrovascular accident.

Fifty-seven patients (34 men and 23 women) who were rehabilitated following cerebrovascular accident were included in the analysis. Subjects with maximum contractile power values less than 10 W/m(2) in men and 8 W/m(2) in women, in the absence of bladder outlet obstruction, were defined as having detrusor underactivity.

A significantly lower maximum value of detrusor contractile power and a larger residual urine volume, particularly more prevalent in women than in men, appeared unexpectedly after cerebrovascular accident. Patients with underactivity had significantly lower maximum and average flow rates, lower contractile power, and an increased postvoid residual relative to their normal counterparts. The prevalence of underactivity was 35% in the men and 43% in the women. Furthermore, 67% of the men and 80% of the women with underactivity had overactive bladder symptoms. On the other hand, detrusor underactivity was observed in 8 (35%) of 23 overactive bladder patients in the men and 8 (42%) of 19 in the women.

Post-cerebrovascular accident patients presented various patterns of detrusor contractility. Specific attention to the possible occurrence of detrusor underactivity in these patients is essential for the successful management of overactive bladder syndrome.