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Bladder Compliance in Men with Lower Urinary Tract Symptoms.
Kristina Wittig1, Jerry Blaivas2, Jeffrey Weiss3, Georgia Panagopoulos4
1University of Connecticut Health Center, Farmington, CT;2Weill Cornell Medical Center, New York, NY;3SUNY Downstate, Brooklyn, NY;4Lenox Hill, New York, NY

Introduction:
To determine whether there is a relationship between bladder compliance in men with lower urinary tract symptoms (LUTS) and the degree of urethral obstruction, prostate size, detrusor overactivity, and age.
Materials & Methods:

Retrospective observational study of consecutive men 18 years of age
or older, identified from our database, who underwent evaluation for persistent LUTS. All patients underwent history & physical examination, voiding diary, urinalysis & urine culture, cystoscopy & videourodynamics. Exclusion criteria: urethral stricture, prostate cancer, prostate surgery, active bladder cancer, neurogenic bladder.
Urethral obstruction was defined by the Schafer bladder outlet obstruction nomogram (grades obstruction 0-6).
Prostate size was defined as 0-4+ (0 = smaller than normal, 1+ = normal, 2 - 4+ = increasing prostatic size).

Results:

Of 314 patients screened, 229 were excluded because of one or more exclusion criteria. The 85 remaining patients ranged in age from 31-89 yrs (mean = 63, SD = 13). An inverse correlation was found between bladder compliance & Schafer obstruction grade (Spearman's rho= -.276, p=.011). No correlation was noted between bladder compliance and prostate size (Spearman's rho=.076, p=. 50), detrusor overactivity (Spearman's rho= -.17, p=.33) or age (Spearman's rho=.01, p=.93).

Conclusions:

Since low bladder compliance is an important risk factor for the development of upper urinary tract disease, proactive treatment and careful monitoring of patients with high degrees of urethral obstruction should be considered.


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