The change in urodynamic parameters in young men with bladder neck obstruction following surveillance periods

Objective

To evaluate the change in bladder dysfunction in men diagnosed with bladder neck obstruction (BNO) < 50 years of age following surveillance periods.

Methods

We retrospectively analysed changes in urodynamic parameters in men <50 years of age diagnosed with BNO during video urodynamics (VUDS) from initial presentation to subsequent investigations following a minimum surveillance period of 2 years.

Results

Ten men (mean age 33 ± 14 years) with a mean surveillance period of 4.8 ± 1.9 years were recruited. 5/10 men were taking alpha blockers during this period. 7/10 demonstrated detrusor overactivity (DO) during initial urodynamics. There was a mean (±SD) increase in DO peak pressure of 11.9(±75.1) $cm{H}_{2}O$ (p = 0.648). There was a mean (±SD) reduction in bladder compliance of 23.84 $ml/cm{H}_{2}O$ (±31.1 $ml/cm{H}_{2}O)$ (p = 0.067). There was no change in cystometric capacity (p = .998), detrusor pressure at maximum flow $\left(P_{\det .Qmax}\right)$ (p = .211), bladder outlet obstruction index (BOOI) (p = .227) or post void residual (PVR) (p = .707). There was a moderate correlation between BOOI and $P_{\det .Qmax}$ at initial urodynamics with the change in compliance over the surveillance period (0.56 and 0.49 respectively). The peak DO pressure at baseline correlates most with the reduction in $Q_{\max }$ during surveillance period (−0.6).

Conclusion

The rate of change of bladder dysfunction appears variable in men with BNO. However, our study indicates a trend of worsening loss of compliance and Qmax over a mean period of ∼5 years which appears moderately correlated with the BOOI and DO peak pressures measured at initial urodynamics.