Clinical diagnostic criteria for detrusor underactivity: A report from the Japanese Continence Society working group on underactive bladder

Yoshida, Masaki; Sekido, Naritoshi; Matsukawa, Yoshihisa; Yono, Makoto; Yamaguchi, Osamu

doi:10.1111/luts.12356

Cited by 16 publications

(27 citation statements)

References 18 publications

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“…The optimal cutoff value for prostate volume for the diagnosis of pure DU was 39 mL in the present study. The Japanese Continence Society consensus group has proposed prostate volume <30 mL as one of the clinical diagnostic criteria for DU 8 . Our data were similar to that criterion.…”

Section: Discussionsupporting

confidence: 82%

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Clinical features of detrusor underactivity in elderly men without neurological disorders

Kiba

Akashi

Yamamoto

et al. 2022

LUTS

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Objectives: To investigate the clinical features of detrusor underactivity (DU) in elderly men without neurological disorders. Methods: A total of 336 men aged ≥50 years without neurogenic disorders who underwent pressure flow studies and who had DU or bladder outlet obstruction (BOO) were reviewed retrospectively. According to the bladder contractility index (BCI) and the BOO index (BOOI), the subjects were classified into the following three groups: (a) pure DU group, BCI < 100 and BOOI < 40; (b) DU + BOO group, BCI < 100 and BOOI ≥ 40; and (c) pure BOO group, BCI ≥ 100 and BOOI ≥ 40. Subjective and objective parameters were compared among the three groups, and the predictors for pure DU were evaluated by multivariate analysis. Results: Of the 336 patients, 205 who met the study criteria were included in the analysis: 63 (30.7%) with pure DU, 48 (23.4%) with DU + BOO, and 94 (45.9%) with pure BOO. The proportion of the pure DU group increased with increasing age. Prostate volume was the lowest in the pure DU group. Frequency, urgency on the International Prostate Symptom Score (IPSS), and the IPSS storage subscore were the lowest in the pure DU group. Multivariate analysis showed that age (odds ratio [OR] 1.114 [95% CI, 1.032-1.203], P = .005), prostate volume (OR 0.968 [95% CI, 0.949-0.987], P = .001), and urgency (OR 0.623 [95% CI, 0.431-0.900], P = .012) were predictors of pure DU. Conclusion: Older age, smaller prostate volume, and less urgency may be clinical features of pure DU.

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Section: Discussionsupporting

confidence: 82%

“…5 In recent years, there have been several reports on the clinical features of DU. [6][7][8] However, it has not yet been established because research subjects and diagnostic criteria for DU vary by studies.…”

Section: Introductionmentioning

confidence: 99%

Clinical features of detrusor underactivity in elderly men without neurological disorders

Kiba

Akashi

Yamamoto

et al. 2022

LUTS

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“…However, differentiating DU from BOO without PFS is difficult. Recently, UAB has been identified as a symptom syndrome caused by DU 19,20 . The ICS consensus group proposed that “UAB is characterized by a slow urinary stream, hesitancy and straining to void, with or without a feeling of incomplete bladder emptying sometimes with storage symptoms”; 19 however, these symptoms are also seen in patients with BOO and are not characteristic of DU.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, with a low UFM urine volume (≤100 mL), accurate evaluation tends to be difficult 19,20,22 . Nevertheless, this AI system can provide diagnoses even from low urine volume UFM waveforms by learning many patient datasets.…”

Section: Discussionmentioning

confidence: 99%

Development of an artificial intelligence diagnostic system for lower urinary tract dysfunction in men

et al. 2021

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Objectives To establish an artificial intelligence diagnostic system for lower urinary tract function in men with lower urinary tract symptoms using only uroflowmetry data and to evaluate its usefulness. Methods Uroflowmetry data of 256 treatment‐naive men with detrusor underactivity, bladder outlet obstruction, or detrusor underactivity + bladder outlet obstruction were used for artificial intelligence learning and validation using neural networks. An optimal artificial intelligence diagnostic model was established using 10‐fold stratified cross‐validation and data augmentation. Correlations of bladder contractility index and bladder outlet obstruction index values for the artificial intelligence system and pressure flow study values were examined using Spearman’s correlation coefficients. Additionally, diagnostic accuracy was compared between the established artificial intelligence system and trained urologists with uroflowmetry data of 25 additional patients by χ2‐tests. Detrusor underactivity was defined as bladder contractility index ≤100 and bladder outlet obstruction index ≤40, bladder outlet obstruction was defined as bladder contractility index >100 and bladder outlet obstruction index >40, and detrusor underactivity + bladder outlet obstruction was defined as bladder contractility index ≤100 and bladder outlet obstruction index >40. Results The artificial intelligence system’s estimated bladder contractility index and bladder outlet obstruction index values showed significant positive correlations with pressure flow study values (bladder contractility index: r = 0.60, P < 0.001; bladder outlet obstruction index: r = 0.46, P < 0.001). The artificial intelligence system’s detrusor underactivity diagnosis had a sensitivity and specificity of 79.7% and 88.7%, respectively, and those for bladder outlet obstruction diagnosis were 76.8% and 84.7%, respectively. The artificial intelligence system’s average diagnostic accuracy was 84%, which was significantly higher than that of urologists (56%). Conclusions Our artificial intelligence diagnostic system developed using the uroflowmetry waveform distinguished between detrusor underactivity and bladder outlet obstruction with high sensitivity and specificity in men with lower urinary tract symptoms.

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“…[ 2 ] Currently, an invasive urodynamic study is the only investigation to estimate detrusor voiding function. [ 3 ] Management commonly involves bladder drainage techniques or drugs aimed at reducing bladder outflow resistance. We report an uncommon presentation of the underactive urinary bladder in a 73 years old male.…”

Section: Introductionmentioning

confidence: 99%

Underactive urinary bladder – Masquerading as abdominal ascites

Bhardwaj

Sinha

2022

Journal of Family Medicine and Primary Care

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An impaired ability to evacuate the urinary bladder is commonly seen in both men and women with aging. Usually, patients present with a range of storage, voiding, and post-micturition urinary symptoms. It may eventually lead to urinary retention. These symptoms may have a considerable effect on the patient’s quality of life. Despite its common prevalence with advancing age, the etiopathogenesis of the underactive urinary bladder is incompletely understood. There are no widely agreed diagnostic criteria. The urodynamic study (UDS), an invasive investigation is the only accepted modality to diagnose underactive detrusor. There is a lack of effective treatments to improve bladder emptying. The goals of treatment are to improve symptoms and reduce the risk for the complications of impaired bladder emptying. We report a case of a 73 year male who came to us with a history of urinary symptoms and a distended abdomen.

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Clinical diagnostic criteria for detrusor underactivity: A report from the Japanese Continence Society working group on underactive bladder

Cited by 16 publications

References 18 publications

Clinical features of detrusor underactivity in elderly men without neurological disorders

Clinical features of detrusor underactivity in elderly men without neurological disorders

Development of an artificial intelligence diagnostic system for lower urinary tract dysfunction in men

Underactive urinary bladder – Masquerading as abdominal ascites

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