Bladder Oversensitivity Is Associated with Bladder Outlet Obstruction in Men
Objective: The aim of this study was to assess whether there is an objective association between bladder outlet obstruction (BOO) and abnormal sensation parameters during filling cystometry in men. Methods: This was a prospective study. Consecutive patients referred for urodynamic examination were a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/10/1675 |
| _version_ | 1797472173048201216 |
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| author | Guy Verhovsky Ilia Baberashvili Yishai H. Rappaport Dorit E. Zilberman Amos Neheman Jonathan Gal Amnon Zisman Kobi Stav |
| author_facet | Guy Verhovsky Ilia Baberashvili Yishai H. Rappaport Dorit E. Zilberman Amos Neheman Jonathan Gal Amnon Zisman Kobi Stav |
| author_sort | Guy Verhovsky |
| collection | DOAJ |
| description | Objective: The aim of this study was to assess whether there is an objective association between bladder outlet obstruction (BOO) and abnormal sensation parameters during filling cystometry in men. Methods: This was a prospective study. Consecutive patients referred for urodynamic examination were assessed for eligibility. Patients with permanent catheters, BPH related surgery, neurologic disease, or inability to complete the urodynamic study were excluded. All patients underwent full physical examination, as well as renal and bladder ultrasound including prostate size estimation, post void residual volume, and PSA, and they completed the International Prostate Symptoms Score (IPSS) questionnaire. The cohort was divided into obstructed and un-obstructed groups according to the Bladder Outlet Obstruction Index. Results: Ninety of the 115 patients recruited were obstructed (78%). Obstructed patients had significantly higher PSA, larger prostate volume, and higher IPSS. Detrusor overactivity did not differ between the two groups (45.6% vs. 48.1%, <i>p</i> = 0.83). First, normal, strong, and urgent desires to void were significantly lower in obstructed men: median (IQR) 118 (57–128) vs. 180 (80–200), 171 (85–257) vs. 227 (125–350), 221 (150–383) vs. 307 (180–477), and 276 (197–480) vs. 344 (280–535), respectively. First desire to void (FDV) had the highest area under the curve (AUC = 0.83, 95% CI = 0.76–0.90, <i>p</i> < 0.001) for predicting BOO with a Youden index of 0.78 at 140 mL. Conclusions: Our results suggest that there is a strong association between bladder oversensitivity and BOO in men. Men with FDV <140 mL had a significantly increased probability of being obstructed. These findings may shed a light on the pathophysiological connection between obstruction and enhanced afferent signaling from the bladder. |
| first_indexed | 2024-03-09T19:59:19Z |
| format | Article |
| id | doaj.art-be426f5d55894f019a0812ba2ed1bddd |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T19:59:19Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-be426f5d55894f019a0812ba2ed1bddd2023-11-24T00:50:11ZengMDPI AGJournal of Personalized Medicine2075-44262022-10-011210167510.3390/jpm12101675Bladder Oversensitivity Is Associated with Bladder Outlet Obstruction in MenGuy Verhovsky0Ilia Baberashvili1Yishai H. Rappaport2Dorit E. Zilberman3Amos Neheman4Jonathan Gal5Amnon Zisman6Kobi Stav7Department of Urology, Shamir Medical Center (Assaf Harofeh Campus), Zerifin, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelDepartment of Nephrology, Shamir Medical Center (Assaf Harofeh Campus), Zerifin, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelDepartment of Urology, Samson Assuta Medical Center, Ashdod, Goldman School of Medicine, Ben-Gurion University of the Negev, Beer Sheva 84105, IsraelDepartment of Urology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelDepartment of Urology, Shamir Medical Center (Assaf Harofeh Campus), Zerifin, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelDepartment of Urology, Shamir Medical Center (Assaf Harofeh Campus), Zerifin, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelDepartment of Urology, Shamir Medical Center (Assaf Harofeh Campus), Zerifin, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelDepartment of Urology, Shamir Medical Center (Assaf Harofeh Campus), Zerifin, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelObjective: The aim of this study was to assess whether there is an objective association between bladder outlet obstruction (BOO) and abnormal sensation parameters during filling cystometry in men. Methods: This was a prospective study. Consecutive patients referred for urodynamic examination were assessed for eligibility. Patients with permanent catheters, BPH related surgery, neurologic disease, or inability to complete the urodynamic study were excluded. All patients underwent full physical examination, as well as renal and bladder ultrasound including prostate size estimation, post void residual volume, and PSA, and they completed the International Prostate Symptoms Score (IPSS) questionnaire. The cohort was divided into obstructed and un-obstructed groups according to the Bladder Outlet Obstruction Index. Results: Ninety of the 115 patients recruited were obstructed (78%). Obstructed patients had significantly higher PSA, larger prostate volume, and higher IPSS. Detrusor overactivity did not differ between the two groups (45.6% vs. 48.1%, <i>p</i> = 0.83). First, normal, strong, and urgent desires to void were significantly lower in obstructed men: median (IQR) 118 (57–128) vs. 180 (80–200), 171 (85–257) vs. 227 (125–350), 221 (150–383) vs. 307 (180–477), and 276 (197–480) vs. 344 (280–535), respectively. First desire to void (FDV) had the highest area under the curve (AUC = 0.83, 95% CI = 0.76–0.90, <i>p</i> < 0.001) for predicting BOO with a Youden index of 0.78 at 140 mL. Conclusions: Our results suggest that there is a strong association between bladder oversensitivity and BOO in men. Men with FDV <140 mL had a significantly increased probability of being obstructed. These findings may shed a light on the pathophysiological connection between obstruction and enhanced afferent signaling from the bladder.https://www.mdpi.com/2075-4426/12/10/1675bladder outlet obstructionurodynamicsbladder oversensitivityoveractive bladder |
| spellingShingle | Guy Verhovsky Ilia Baberashvili Yishai H. Rappaport Dorit E. Zilberman Amos Neheman Jonathan Gal Amnon Zisman Kobi Stav Bladder Oversensitivity Is Associated with Bladder Outlet Obstruction in Men Journal of Personalized Medicine bladder outlet obstruction urodynamics bladder oversensitivity overactive bladder |
| title | Bladder Oversensitivity Is Associated with Bladder Outlet Obstruction in Men |
| title_full | Bladder Oversensitivity Is Associated with Bladder Outlet Obstruction in Men |
| title_fullStr | Bladder Oversensitivity Is Associated with Bladder Outlet Obstruction in Men |
| title_full_unstemmed | Bladder Oversensitivity Is Associated with Bladder Outlet Obstruction in Men |
| title_short | Bladder Oversensitivity Is Associated with Bladder Outlet Obstruction in Men |
| title_sort | bladder oversensitivity is associated with bladder outlet obstruction in men |
| topic | bladder outlet obstruction urodynamics bladder oversensitivity overactive bladder |
| url | https://www.mdpi.com/2075-4426/12/10/1675 |
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