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Detrusor hyperreflexia--are there two types?

A Lord1, H Eastwood

  • 1Department of Medicine for the Elderly, Southampton General Hospital.

Age and Ageing
|January 1, 1994
PubMed
Summary
This summary is machine-generated.

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This study reassesses elderly urinary incontinence subgroups. Findings suggest detrusor contractility measures vary, challenging the two-group concept for detrusor hyperreflexia patients.

Area of Science:

  • Urology
  • Geriatrics
  • Neurology

Background:

  • Urinary incontinence in elderly patients is often linked to detrusor hyperreflexia.
  • Previous concepts proposed dividing these patients into two subgroups based on detrusor contractility.
  • These subgroups were thought to have different natural histories.

Purpose of the Study:

  • To reassess the concept of two distinct subgroups of elderly patients with urinary incontinence due to detrusor hyperreflexia.
  • To evaluate if detrusor contractility measurements consistently define these subgroups.

Main Methods:

  • Thirty patients with urinary incontinence and detrusor hyperreflexia post-neurological lesion underwent urodynamic studies.
  • Detrusor contractility was measured using post-contraction residual urine volume and detrusor pressure increase rate.

Related Experiment Videos

  • Cystometry was repeated three times on the same occasion to assess consistency.

    • Main Results:

    • A spectrum of values was observed for post-contraction residual volumes and detrusor pressure increase rates.
    • Eleven out of thirty patients exhibited variable post-contraction residual volumes upon repetitive cystometry.
    • Impaired contractility was common, but results did not support the existence of two distinct subgroups.

    Conclusions:

    • The proposed division of detrusor hyperreflexia patients into two subgroups based on cystometry findings is not supported by this study.
    • Cystometric measures of detrusor contractility can be inconsistent within the same patient on repeated testing.