BPH with coexisting overactive bladder dysfunction—an everyday urological dilemma

Abstract

The aim of this study was to use a systematic schedule, including urodynamics, to describe the rate of coexisting overactive bladder (OB) in patients with bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia (BPH). We also identified differences between the patients with pure BOO compared with those with BOO combined with OB (BOO + OB). One hundred and sixty-two men referred to our clinic due to LUTS were included. Patients with a history that might affect their bladder function were excluded. After cystometry and pressure-flow studies, the patients were divided into pure BOO and BOO + OB. Of the 162 men, 55% had pure BOO. BOO + OB was found in 45%. Age, s-PSA, voided volume, and obstruction grade differed significantly between the groups. The patients with BOO + OB were older, had a higher s-PSA, voided smaller volumes, and were more obstructed. We found no differences in TRUS-volume, Q-max, IPS score, or PVR. There was a strong association between OB and BOO, the percentage of OB increasing with increased obstruction. TRUS-volume, Q-max, IPS score, and PVR did not predict whether the patients had a combined BOO + OB or not. These findings indicate that BOO is a progressive disease, which in time causes pronounced obstruction and perhaps in itself contributes to the development of OB.

Prediction of Persistent Storage Symptoms after Transurethral Resection of the Prostate in Patients with Benign Prostatic Enlargement

“…In another study of 100 consecutive patients who underwent TURP, a high proportion of patients reported increasing urine leakage with increasing age [9]. Knutson et al [10] reported that high age was an independent risk factor for coexisting detrusor overactivity in BPE.…”

Mechanical stretch regulates cell survival in human bladder smooth muscle cells in vitro

“…These findings are considered common to most conditions leading to detrusor instability (4). Although there is a strong association among outlet obstruction (17), neurological disease (1), and bladder overactivity, little is known about the events that lead to these changes or the underlying mechanisms involved.…”

A gap junction blocker inhibits isolated whole bladder activity in normal rats and rats with partial bladder outlet obstruction

“…Clinically, detrusor overactivity is common in patients with benign prostatic hyperplasia and outfl ow obstruction (11), and Connexin43 expression is increased in patients with neurogenic detrusor overactivity (10). Our present fi ndings suggest that bladder activity is more effectively inhibited by a gap junction blocker after BOO has increased the number of gap junctions.…”

“…Bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia in elderly men is associated with detrusor overactivity, which is also the most common cause of overactive bladder syndrome (11). Partial BOO is an established experimental model for producing detrusor overactivity in animals, which causes signifi cant changes of bladder smooth muscle contraction (17).…”