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Detrusor instability as an energy-saving device in prostatic obstruction
A Cucchi1, M P Achilli, S Ravasi
1Divisione di Urologia, Policlinico S. Matteo, Pavia, Italy.
The Journal of Urology
|March 1, 1997
Summary
Patients with benign prostatic hyperplasia and detrusor instability void more efficiently by using less energy. This suggests detrusor instability may be an energy-saving mechanism in men with prostate disease.
Area of Science:
- Urology
- Physiology
Background:
- Benign prostatic hyperplasia (BPH) commonly causes infravesical obstruction.
- Voiding dynamics in BPH patients can be affected by detrusor muscle function.
Purpose of the Study:
- To compare voiding dynamics in BPH patients with and without detrusor instability.
- To investigate the role of detrusor instability in infravesical obstruction.
Main Methods:
- Urodynamic assessment including cystometry and pressure-flow studies.
- Involved 50 male patients with BPH, divided into groups with (n=25) and without (n=25) detrusor instability.
Main Results:
- Patients with detrusor instability exhibited greater obstruction but expended less energy per voided volume.
- The unstable group demonstrated more powerful detrusor contractions and higher voiding efficiency.
- Mean energy expenditure per unit volume was 54.4 mJ/ml in the unstable group vs. 74.4 mJ/ml in the stable group.
Conclusions:
- Detrusor instability may function as an energy-saving mechanism in BPH patients.
- This mechanism potentially preserves voiding efficiency despite increasing obstruction.
- Findings suggest a compensatory role for detrusor instability in managing infravesical obstruction.