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The development of detrusor instability in prostatic obstruction in relation to sequential changes in voiding
1Divisione di Urologia, Policlinico S. Matteo, Pavia, Italy.
The Journal of Urology
|May 1, 1994
Summary
Benign prostatic hypertrophy patients with infravesical obstruction showed worsening bladder instability and increased opening pressures over time. Despite these changes, urine flow rates remained stable, with enhanced voiding power observed in some cases.
Area of Science:
- Urology
- Physiology
Background:
- Benign prostatic hypertrophy (BPH) is a common condition causing infravesical obstruction.
- High opening pressures and stable bladders characterize some BPH patients.
- The natural progression of voiding mechanics in such patients requires further investigation.
Purpose of the Study:
- To evaluate the long-term changes in voiding dynamics in patients with benign prostatic hypertrophy and infravesical obstruction.
- To assess the impact of obstruction on bladder stability and detrusor function over time.
Main Methods:
- A cohort of 34 patients with BPH and infravesical obstruction were monitored.
- Patients received no active treatment, only intermittent plant extracts.
- Voiding dynamics were reassessed after a mean of 21 months.
Main Results:
- 12 patients maintained a stable bladder; 22 developed unstable bladders with significantly increased opening pressures.
- Peak flow pressure increased, while driving pressure and bladder volume decreased.
- Urine flow rates remained unchanged, and maximum external voiding power was enhanced.
Conclusions:
- Benign prostatic hypertrophy progression can lead to increased bladder instability and detrusor pressure.
- Despite worsening obstruction, compensatory mechanisms may maintain urine flow rates and enhance voiding power.
- These findings highlight the complex interplay between obstruction and bladder function in BPH.