Abstract
We describe the pathophysiology, differential diagnosis and urodynamic findings in patients with a large capacity bladder. This was a retrospective, observational study of 100 consecutive patients with voiding dysfunction and a cystometric bladder capacity of greater than 700 ml. Clinical data, cystometric bladder capacity and other urodynamic findings were evaluated. Bladder outlet obstruction and impaired detrusor contractility were defined by the Schaefer nomogram in men and the Blaivas-Groutz nomogram in women. A total of 56 men and 44 women 36 to 97 years old (median age 75, mean 71.2) with a bladder capacity of 700 to 5,013 ml (median 931, mean 1,091) were studied. The primary pathophysiological diagnoses were bladder outlet obstruction in 48% of cases, impaired detrusor contractility in 11%, absent detrusor contractility in 24% and normal detrusor pressure/uroflow study in 17%. Bladder outlet obstruction was attributable to anatomical obstruction in 34% of patients, acquired voiding dysfunction in 11% and detrusor-external sphincter dyssynergia in 3%. In patients with detrusor contractions the initial contraction occurred at a median of 1,000 ml (mean 1,154, range 86 to 5,000). Associated diagnoses in men included benign...Continue Reading
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