Clinical Epidemiology: Detrusor Voiding Contraction Maximum Power, Related to Ageing.

OBJECTIVE: To report clinical epidemiology of detrusor (bladder) muscle contraction maximum related to ageing in patients referred with signs and symptoms of lower urinary tract dysfunction. STUDY DESIGN AND SETTING: One thousand three hundred and eight urodynamic pressure-flow measurements were analyzed in retrospective. Standard measures of detrusor muscle voiding contraction strength were compared for gender and ranked by age (range 20-90 years). RESULTS: A decline in maximum detrusor contraction strength was observed when the results were ranked according to age. Detrusor muscle maximum voiding contraction was on average 30% less powerful in older women and 12% less powerful in the aged men, when compared to the younger. This is transversal data-interpreted in a longitudinal manner-and from persons referred to specialist care with (the full spectrum of) signs and symptoms of lower urinary tract dysfunction. Therefore these results are relevant for clinical epidemiology but not definitely generalizable to (symptom-free) population level. CONCLUSIONS: Clinical epidemiologic evaluation of patients referred with lower urinary tract symptoms, found lower detrusor maximum contraction strength in higher-age cohorts, both for women as for men. The maximum detrusor strength difference in association with age was larger in women than in men.

Rare case of urinary tract infections and the "forgotten" solution.

This report presents a rare case of recurrent urinary tract infections in a kidney transplant patient. Analysis revealed a ureteral stump calculus 31 years after bilateral nephrectomy which was disintegrated by means of flexible ureteroscopy and holmium laser. In case of unexplained recurrent urinary tract infections and abdominal pain, urolithiasis in the ureteral stumps should be considered.