Improving Urodynamic Prediction of Non-Neurogenic Underactive Detrusor in Adult Male Patients

Introduction: Non-neurogenic detrusor underactivity (DU) is a common diagnosis in patients. Symptoms of DU may include urinary frequency, urinary urgency, weak stream, straining to void, urinary incontinence, infrequent urination, decreased voiding sensation, increased post-void residual volume, and chronic urinary retention. Background: Urinary symptoms are not specific to DU, and may be associated with a myriad of other diagnoses. DU has been poorly defined in the literature with lack of evidence-based outcomes. The literature review identifies gaps in the literature regarding the predictive value of urodynamic parameters in relation to adult patients with DU, thus supporting analysis of the association of clinical diagnosis of detrusor underactivity and urodynamic parameters of detrusor pressure at max flow (Pdet@Qmax), Watts Factor (WF), bladder contractility index (BCI), and Schafer’s linear passive urethral resistance relation (LinPURR) detrusor contractility nomogram for evaluation of DU identification. Methods: Predictive outcomes as measured by comparison of clinician diagnosis of non-neurogenic underactive detrusor pre- and post- UDS evaluation of adult male patients was performed at an outpatient urology practice in southwestern VA. Results: Record review included all male patients with lower urinary tract symptoms (LUTS) undergoing UDS for a twelve-month timeframe of 9/2018 to 9/2019, showing a statistically significant relationship between PVR and age as well as Watts factor and DU diagnosis. Implications: The observed correlations support findings in the literature review. While BCI and LinPURR did not show statistically significant correlations with DU diagnosis, this analysis is limited due to small sample size.