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Structural basis of geriatric voiding dysfunction. VII. Prospective ultrastructural/urodynamic evaluation of its
A Elbadawi1, S Hailemariam, S V Yalla
1Department of Pathology, State University of New York, Health Science Center, Syracuse 13210, USA.
The Journal of Urology
|May 1, 1997
Summary
Geriatric detrusor ultrastructure changes correlate with urodynamic function over time. These ultrastructural changes may precede or coincide with functional alterations, indicating a close relationship.
Area of Science:
- Gerontology
- Urology
- Pathology
Background:
- Cross-sectional studies show a correlation between geriatric detrusor ultrastructure and urodynamic behavior.
- The stability and predictive nature of these ultrastructural changes over time require further investigation.
Purpose of the Study:
- To determine if ultrastructural observations of geriatric detrusors are stable over time.
- To assess if ultrastructural changes occur concurrently with urodynamic changes.
- To investigate whether ultrastructural changes predict or precede urodynamic alterations.
Main Methods:
- Twenty-three elderly subjects underwent clinical and urodynamic evaluation, along with endoscopic detrusor biopsy for ultrastructural study.
- Subjects were followed for up to 67 months, with repeated evaluations in a subset.
- Biopsies were classified by ultrastructural patterns, blinded to clinical and urodynamic data, followed by correlation analysis.
Main Results:
- At baseline, ultrastructural and urodynamic diagnoses matched in all 23 subjects.
- After one follow-up, 70% showed unchanged diagnoses, while 30% exhibited concordant changes in both ultrastructure and urodynamics.
- In subjects with two follow-ups, some showed stable diagnoses, while others developed a dysjunction pattern with detrusor overactivity.
Conclusions:
- Detrusor ultrastructure consistently corresponds with urodynamic behavior over time, regardless of functional stability or change.
- While the precise temporal sequence remains unclear, ultrastructural changes are not solely a consequence of long-standing functional alterations.
- Auxiliary ultrastructural features may indicate transitional changes preceding the development of distinct patterns and associated urodynamic abnormalities.