Idiopathic detrusor Idiopathic detrusor overactivityoveractivity: prevalence of underlying : prevalence of underlying neurological disease and its neurological disease and its urodynamicurodynamic profileprofile

Ordaz G, Avargues A, Arlandis S, Gallego A, Plaza B, Martinez-Cuenca E, Broseta E.Department of neurourology, La Fe university and polytechnic hospital. Valencia, Spain.

AIM

To asses the prevalence of undiagnosed neuropathology in patients with theoretical idiopathic detrusor overactivity (IDO) and define a possible characteristic urodynamic profile for each diagnosis.

MATERIALS AND METHODS

CONCLUSIONS

RESULTS

Fig 1. Descriptive results; patients pergroup.

Fig 2-7. Boxplots compare each of thefour neurological groups (blue) againstidiopathic (green).

P value is only displayed over thesignificant differences.

48; 26%

12; 7%

2; 1%

7; 4%

5; 3%

108; 59%Spinal cordBrain org.ParkinsonAlzheimerOthersIdiopathic

1

2 3

4 5

6 7

DISCUSSIONSignificant low BCI in Alzheimer group could be due to older age as it is also significant. Parkinson results such as low bladder capacity, low volumes for normal bladder sensation, low flow rates with high RV although significant, should be interpreted with caution as the sample is too small (n=2).Compressive spinal disc, was the most frequent diagnosis 40,7%, CI 95% (33,24-48,07).

There is no clear urodynamic profile in this study that would predict underlying neurological disease, whereas there is a significant high prevalence in our sample of spinal cord pathology.

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Retrospective study. From January 2001 to January 2010 we included all urodynamic tests resulting in IDO diagnosis.Both sexes, not meeting the exclusion criteria (diabetes mellitus, prostate hyperplasia, urinary infection, previously diagnosed neurological conditions, bladder, urethra or prostate previous surgery or neoplasm, abnormal anatomical findings in the urinary tract, renal transplantation and urethral stricture)183 total medical records were reviewed looking for any relevant neurological diagnosis from date of urodynamics until march 2013.Variables:

Age, gender, date of urodinamyc study, date of neurological diagnosis, bladder compliance, maximum cystometric capacity, volume at first involuntary contraction (IC), normal bladder sensation, maximum detrusor pressure during IC, detrusor pressure in maximum flow rate, opening detrusor pressure, maximum flow rate, average flow rate, residual volume, cavernosus reflex, perineal sensation, bladder-sphincter synergy and bladder contraction index (BCI).

Five subanalysis groups according to neurological pathology findings (Spinal cord pathology, brain organic pathology, Parkinson syndrome, Alzheimer dementia, idiopathic).Fisher and ANOVA tests with SPSS v18®