Buscar en
Actas Urológicas Españolas (English Edition)
Toda la web
Inicio Actas Urológicas Españolas (English Edition) Evolution of male patients with detrusor underactivity and conservative treatmen...
Journal Information
Vol. 45. Issue 1.
Pages 83-89 (January - February 2021)
Share
Share
Download PDF
More article options
ePub
Visits
6
Vol. 45. Issue 1.
Pages 83-89 (January - February 2021)
Original article
Evolution of male patients with detrusor underactivity and conservative treatment. Five-year follow-up
Evolución de pacientes varones con detrusor hipoactivo y tratamiento conservador. Seguimiento a cinco años
Visits
...
E. Morán
Corresponding author
edumoranpascual@gmail.com

Corresponding author.
, I. Sáez, J. Bolón, O. Colet, M.A. Bonillo, E. Martínez-Cuenca, E. Broseta, S. Arlandis
Sección de Urología Funcional y Reconstructiva, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Tables (3)
Table 1. Uroflowmetric and urodynamic variables of men with DU at the time of diagnosis.
Table 2. Etiology of patients with DU.
Table 3. Baseline parameters of patients with NDU and NNDU who started conservative treatment.
Show moreShow less
Abstract
Introduction

The objective of the study was to compare the evolution of male patients with neurogenic detrusor underactivity (NDU) versus non-neurogenic DU (NNDU) and to establish risk factors to predict the need for clean intermittent catheterization (CIC) during the follow-up period.

Material and methods

Longitudinal, descriptive study of a cohort of patients diagnosed with DU, and 2496 urodynamic studies (2008–2018) were reviewed. Patients with DU (ICS 2002 and/or Bladder contraction index (<100)) without treatment were included. Patients with CIC or interventional treatment were excluded. Follow-up included flowmetry every six months. CIC was indicated in cases of high residual volume (PVR) >200mL or voiding efficiency (VE) <50%. The need for CIC during follow-up or the appearance of complications (urinary tract infections (UTI), bladder lithiasis) were compared.

Results

DU was found in 172 (6.89%) men. Neurological causes were observed in 106 (61,6%) cases. Finally, 62 patients were included with a mean follow-up of 4.9 years (±2.6). Of these patients, 33 (53%) presented NDU and 29 (47%) NNDU. Six patients with NDU needed CIC versus none with NNDU (p=0.04). Patients requiring CIC had higher PVR (p=0.009) and lower VE (p=0.017)), and there were also differences in terms of time until the need for CIC (log Rank: 0.009), which was 15.1 months [4–38]. In the multivariate analysis, none of the variables showed to be predictive of the need for CIC.

Conclusions

The most common cause of DU is neurologic injury. Patients with NDU remain stable without requiring CIC. We have not detected any risk factors that identify patients at risk of needing CIC.

Keywords:
Detrusor underactivity
Clean intermittent catheterization
Follow-up
Resumen
Introducción

El objetivo del trabajo fue comparar la evolución de pacientes varones con detrusor hipoactivo (DU) neurógeno (DUN) frente a DU no neurógeno (DUNoN) y establecer factores de riesgo para predecir la necesidad de cateterismo limpio intermitente (CLI) en el seguimiento.

Material y métodos

Estudio longitudinal, descriptivo, sobre una cohorte de pacientes con diagnóstico de DU. Se revisaron 2.496 estudios urodinámicos (2008-2018). Se incluyeron pacientes con DU (ICS2002 y/o Bladder contraction index [< 100]) sin tratamiento. Se excluyeron pacientes en CLI o tratamiento intervencionista. Se realizó seguimiento semestralmente con flujometría. Se indicó CLI ante residuos elevados (RPM) > 200mL o eficiencia de vaciado (EV) < 50%. Se comparó la necesidad de CLI durante el seguimiento o la aparición de complicaciones (infecciones urinarias [ITU], litiasis vesical).

Resultados

Se encontraron 172 (6,89%) varones con DU. En 106 (61,6%) se evidenció causa neurológica. Finalmente se incluyeron 62 pacientes con seguimiento medio de 4,9 años (+/-2,6). De ellos, 33 (53%) fueron DUN y 29 (47%) DUNoN. No se apreciaron diferencias en la aparición de ITU (p=0,34) o litiasis vesicales (p=0,39). Seis pacientes con DUN precisaron CLI frente a ninguno con DUNoN (p=0,04). Los pacientes que requirieron CLI presentaron mayor RPM [p=0,009]) y menor EV [p=0,017]). También se apreciaron diferencias en el tiempo hasta la necesidad de CLI (log rank: 0,009), siendo este de 15,1 meses (4-38). En el análisis multivariante ninguna de las variables pudo demostrarse como factor predictivo de necesidad de CLI.

Conclusiones

La causa más frecuente de DU es la lesión neurológica. Los pacientes con DUN permanecen estables sin necesidad de CLI. No hemos detectado factores de riesgo que identifiquen a los pacientes en riesgo de necesitar CLI.

Palabras clave:
Detrusor hipoactivo
Cateterismo limpio intermitente
Seguimiento

Article

These are the options to access the full texts of the publication Actas Urológicas Españolas (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Actas Urológicas Españolas (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos