Urodynamic Analysis of Old-aged Men with Persistent Lower Urinary Tract Symptoms after Medical Treatments

ABSTRACT

PURPOSE: The cause and pathogenesis of lower urinary tract symptoms (LUTS) in elderly men is unclear. We analyzed the clinical and urodynamic findings of elderly patients with LUTS to search for accurate diagnosis and effective treatments. MATERIALS AND METHODS: We performed a retrospective chart review of 154 male patients older than 65 years old with LUTS who underwent urodynamic studies between January 2002 and December 2008. The patients were divided into irritative and obstructive symptom groups according to their chief complaints. The urodynamic findings between two groups were compared. And the prevalence of detrusor dysfunction (either detrusor underactivity; DU or detrusor overactivity; DO) according to age, history of urinary retention, the presence of an indwelling urethral catheter, neurologic disease, or diabetes was estimated. RESULTS: The mean age of men was 70.8+/-4.5 years. On urodynamics, detrusor dysfunction was detected in 116 (75.4%) of 154 patients. Seventy eight (50.6%) patients showed demonstrable evidence of DU of whom 33 (21.4%) had concomitant DO, while 18 (11.7%) had concomitant bladder outlet obstruction (BOO). BOO and DO was identified in 67 (43.5%) and 71 (46.1%) patients, respectively. The prevalence of was significantly greater in the presence of history of acute urinary retention and an indwelling urethral catheter. CONCLUSION: One hundred forty one (91.6%) elderly patients with LUTS showed urodynamic abnormalities such DO, DU and BOO. Urodynamic study would play a important role in establishing a correct diagnosis in elderly patients with LUTS and deciding on additional treatments.