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Detrusor contraction power parameters (BCI and W max) rise with increasing bladder outlet obstruction grade in men with lower urinary tract symptoms: results from a urodynamic database analysis

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Abstract

Purpose

To investigate to what extent detrusor work during voiding is influenced by bladder outlet obstruction (BOO) in adult men with lower urinary tract symptoms (LUTS).

Materials and methods

We reviewed data of patients with LUTS suggestive of benign prostatic hyperplasia who received computer-urodynamic investigations as part of their baseline clinical assessment. BOO was defined by the Schäfer classification and detrusor work during voiding was quantified by calculation of the bladder contractility index (BCI) and maximum Watt factor (W max) obtained by pressure-flow analysis.

Results

A total of 786 men with medians of 64 years, IPSS 16 and prostate volume of 35 ml, were included in the study. A total of 462 patients (58.8 %) had BOO (Schäfer 2–6). Both detrusor contraction power parameters continuously increased with rising BOO grade. Median BCI increased from 73.3 in Schäfer 0 to 188.0 in Schäfer 6, whereas W max increased from 9.6 to 23.4 W/m2 (p < 0.001). Results of BCI and W max correlated well (p < 0.001). With increasing BOO grade, there was a significant decrease of voiding efficiency (p < 0.001).

Conclusions

In adult male LUTS patients, detrusor contraction power parameters—BCI and W max—continuously increase with rising BOO grade. According to our results, it is impossible to determine a single threshold value for detrusor contraction power to diagnose detrusor underactivity in a group of LUTS patients with different BOO grades. The study is limited to men with non-neurogenic LUTS. Future studies should evaluate exact threshold values for BCI and W max in BOO subgroups to adequately define detrusor underactivity and investigate men with other bladder conditions.

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Acknowledgments

This study was supported by the Astellas European Foundation Grant 2012.

Conflict of interest

M. Oelke and G. A. van Koeveringe are consultants, speakers and trial participants of Astellas and have been rewarded with the Astellas European Foundation Grant in 2012. K. L. J. Rademakers is employed from money provided by the Astellas European Foundation Grant.

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Authors and Affiliations

  1. Department of Urology, OE 6240, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Matthias Oelke

  2. Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands

    Kevin L. J. Rademakers & Gommert A. van Koeveringe

Authors
  1. Matthias Oelke
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  2. Kevin L. J. Rademakers
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  3. Gommert A. van Koeveringe
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Corresponding author

Correspondence to Matthias Oelke.

Additional information

On behalf of the FORCE Research Group, Maastricht and Hannover.

Matthias Oelke and Kevin L. J. Rademakers have contributed equally to this work.

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Oelke, M., Rademakers, K.L.J. & van Koeveringe, G.A. Detrusor contraction power parameters (BCI and W max) rise with increasing bladder outlet obstruction grade in men with lower urinary tract symptoms: results from a urodynamic database analysis. World J Urol 32, 1177–1183 (2014). https://doi.org/10.1007/s00345-014-1358-6

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  • DOI: https://doi.org/10.1007/s00345-014-1358-6

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