Functional changes during the voiding phase in men with non-neurogenic detrusor underactivity undergoing bladder catheterization

Aims: To investigate urodynamic changes during the voiding phase in men with detrusor underactivity (DU) undergoing bladder catheterization for urinary retention. Methods: From a total of 64 patients, a prospective study was performed in 17 men with a mean age of 77 years. Patients presented a urodynamic diagnosis of DU based on a Bladder Contractility Index (BCI) of <100 and underwent indwelling bladder catheterization (16 cases) or clean intermittent catheterization (1 case) for acute urinary retention (14 cases), or postvoid residual (3 cases). Patients underwent a second urodynamic study after 12 months of follow-up. Fisher's exact test was used with categorical variables and Student's t test with parametric variables. The signification level was set at 95% two-sided. Results: The second urodynamic study showed a significant increase in maximum detrusor pressure, maximum flow rate, BCI, and Bladder Outlet Obstruction Index (BOOI), Conclusion: Bladder catheterization in men with DU significantly improves bladder contractility and reveals lower urinary tract obstructions that were masked by insufficient detrusor pressure related to DU of these patients. These findings could have diagnostic as well as prognostic and therapeutic applications.