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Treatment outcomes of detrusor underactivity in women based on clinical and videourodynamic characteristics

  • Urology - Original Paper
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Abstract

Purpose

Treatment of voiding dysfunction due to detrusor underactivity (DU) remains challenging. This study sought to determine the characteristics of video urodynamic study (VUDS) in female DU and outcomes after active treatment.

Methods

A total of 409 female patients with VUDS-proven DU were recruited. All patients received conservative bladder management, with others receiving active treatment, such as oral medication, transurethral incision of bladder neck (TUI-BN), surgery for prolapse, and urethral botulinum toxin A (BoNT-A) injection, according to their VUDS characteristics. Treatment outcomes were then analyzed by different VUDS characteristics.

Results

Satisfactory treatment outcomes were noted in 123 patients (30.0%), among whom 35 and 88 had a VE of > 90% and > 66.7%, respectively. A total of 165 patients (40.3%) had voiding efficiency (VE) of 33.3–66.7%, whereas 121 (29.6%) remained unable to void (12.5%) or had a VE of < 33.3% (17.1%). Conservative treatment had the worst outcome. Patients with normal or slightly reduced bladder sensation (49.3%) and those with a post-void residual (PVR) of < 250 mL (59.4%) displayed better satisfactory outcome after treatment; while TUI-BN and urethral BoNT-A injection promoted better treatment results. Patients with detrusor acontractility and a PVR of ≥ 500 mL still achieved high VE rates (> 66.7%) after TUI-BN. A 56.3% satisfactory outcome was achieved after TUI-BN, whereas 58.1% satisfactory outcome was noted in those with a tight external sphincter after medical treatment.

Conclusion

Female patients with DU exhibited VE improvement after active treatment. Patients with very low detrusor contractility and absent bladder sensation generally exhibited poor treatment outcomes.

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Funding

This study was supported by the Buddhist Tzu Chi Medical Foundation, Grant TCMF-MP 110-03-01.

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Authors and Affiliations

  1. Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, 707, Section 3, Chung-Yang Road, Hualien, Taiwan

    Sheng-Fu Chen, Jia-Fong Jhang, Yuan-Hong Jiang & Hann-Chorng Kuo

Authors
  1. Sheng-Fu Chen
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  2. Jia-Fong Jhang
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  3. Yuan-Hong Jiang
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  4. Hann-Chorng Kuo
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Contributions

SFC: investigation, data collection, manuscript writing. JFJ: investigation, data collection. YHJ: investigation, data collection. HCK: concept, investigation, manuscript writing, review.

Corresponding author

Correspondence to Hann-Chorng Kuo.

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IRB: 103-145-A.

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Chen, SF., Jhang, JF., Jiang, YH. et al. Treatment outcomes of detrusor underactivity in women based on clinical and videourodynamic characteristics. Int Urol Nephrol 54, 1215–1223 (2022). https://doi.org/10.1007/s11255-022-03175-8

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  • DOI: https://doi.org/10.1007/s11255-022-03175-8

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