Detrusor contractility in post-menopausal women: Impact of ageing, complaint and urodynamic diagnosis

Detrusor contractility (DC) can have a considerable impact on the management oflower urinary tract symptoms (LUTS). However, it is currently impossible to predict, based on clinical data alone, which woman has an impaired DC. Our aim was to determine if DC, assessed by projected isovolumetric pressure-1 (PIP1) and VBN contractility parameter k, was associated with age, main complaint, and urodynamic diagnosis in a population of older women.

Pressure-flow studies of non-neurologic post menopausal women over 65 referred for investigation of LUTS were retrospectively analyzed. Associations between DC indices PIP1 and k, and age, main complaint and urodynamic diagnosis were assessed in univariate analysis.

One hundred and ninety women were included (mean age 74.5 years). There was no significant association between detrusor contractility indices and age considered as a continuous or a categorical variable. Urge urinary incontinence was significantly associated with greater detrusor contractility regardless of age. Regarding urodynamic diagnoses, DC was greater when bladder outlet obstruction and detrusor overactivity were diagnoses vs. detrusor underactivity alone or associated with detrusor overactivity, regardless of age.

PIP1 and k indices allow an easy evaluation of detrusor contractility. In that population of older, post menopausal women, no significant change in the value of the indices is observed with aging whatever the complaint or the urodynamic diagnosis. None of these indices has predominance.

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