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The Aging Lower Urinary Tract: A Comparative Urodynamic Study Of Men And Women.

S. Madersbacher, A. Pycha, G. Schatzl, C. Mian, C. Klingler, M. Marberger
Published 1998 · Medicine

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OBJECTIVES The fact that aging women report similar voiding symptoms as age-matched men prompted us to compare age-related changes of urodynamic parameters in both sexes. METHODS Four hundred thirty-six patients (253 men and 183 women) 40 years of age or older underwent the following investigations: free uroflowmetry, measurement of postvoid residual volume, and full urodynamic testing, including a pressure-flow study (pQs). Additional investigations were a urethral pressure profile in women and quantification of prostate volume by transrectal ultrasonography in men. All men were referred for lower urinary tract symptoms suspicious of bladder outflow obstruction and women predominantly for urinary incontinence. Patients with previous surgery of the lower urinary tract (prostate, bladder, urethra) and those taking medication with a major effect on voiding function (alpha-receptor blockers, 5 alpha-reductase inhibitors, anticholinergic agents) were excluded. RESULTS The mean +/- standard deviation (SD) age in the female (f) population (n = 183) was 59 +/- 16 years (range 40 to 93), in the male population (m) (n = 253) 67 +/- 9 years (range 40 to 90). In both sexes, we observed a statistically significant increase of postvoid residual volume (f: P = 0.0001; m: P = 0.02) and a decrease of peak flow rate (f: P = 0.019; m: P = 0.014), average flow rate (f: P = 0.007; m: P = 0.04), voided volume (f: P = 0.007; m: P = 0.002), and bladder capacity determined by urodynamics (f: P = 0.003; m: P = 0.0004) with progressing age. In both sexes, there were no age-related changes (P >0.05), demonstrable for maximum detrusor pressure and detrusor pressure at peak flow rate. In women, there was a significant decrease of functional urethral length (P = 0.012) and maximum urethral closing pressure (P = 0.0001) with higher age; in men, the prostate volume increased significantly with age (P = 0.0001). With respect to detrusor instability, we observed an increase in men from 23.4% (40 to 60 years) to 46.7% (more than 80 years) (P = 0.004), whereas in women no significant age-related changes were present (P >0.05). CONCLUSIONS These data show that age-associated urodynamic changes in both sexes are comparable for a number of parameters. They provide an explanation for the fact that aging women report comparable voiding symptoms as men and suggest a primary, non-sex-specific aging process of the urinary bladder.
This paper references
The Value of Symptom Score, Quality of Life Score, Maximal Urinary Flow Rate, Residual Volume and Prostate Size for the Diagnosis of Obstructive Benign Prostatic Hyperplasia: A Urodynamic Analysis
G. V. Venrooij (1996)
Prevalence of urinary incontinence and other urological symptoms in the noninstitutionalized elderly.
A. Diokno (1986)
Specificity of the American Urological Association voiding symptom index: comparison of unselected and selected samples of both sexes.
T. Chai (1993)
Structural basis of geriatric voiding dysfunction. I. Methods of a prospective ultrastructural/urodynamic study and an overview of the findings.
A. Elbadawi (1993)
American Urological Association symptom index for women with voiding symptoms: lack of index specificity for benign prostate hyperplasia.
M. Chancellor (1993)
Longitudinal observations on normal and abnormal voiding in men over the age of 50 years.
J. Jørgensen (1993)
Epidemiology of bladder emptying symptoms in elderly men.
A. Diokno (1992)
Prostatic enlargement, symptomatology and pressure/flow evaluation: interrelations in patients with symptomatic BPH.
A. Poulsen (1994)
The effect of age on the autonomic innervation of the urinary bladder.
S. Gilpin (1986)
Structural changes in the aging submucosa: new morphologic criteria for the evaluation of the unstable human bladder.
B. Levy (1990)
International Continence Society "Benign Prostatic Hyperplasia" Study: background, aims, and methodology.
P. Abrams (1997)
The flow rate nomogram: I. Development.
M. Siroky (1979)
Comparison of AUA symptom index in unselected males and females between fifty-five and seventy-nine years of age.
H. Lepor (1993)
Structural basis of geriatric voiding dysfunction. II. Aging detrusor: normal versus impaired contractility.
A. Elbadawi (1993)
Clinical diagnosis of bladder outlet obstruction in patients with benign prostatic enlargement and lower urinary tract symptoms: development and urodynamic validation of a clinical prostate score for the objective diagnosis of bladder outlet obstruction.
P. Rosier (1996)
Uroflowmetry in asymptomatic elderly males.
J. Jørgensen (1986)
Correlation of the AUA symptom index with urodynamics in patients with suspected benign prostatic hyperplasia
V. Nitti (1994)
[Disorders of bladder function in the elderly].
H. Melchior (1995)
Is lamina propria matrix responsible for normal bladder compliance?
D. Ewalt (1992)
Detrusor hyperactivity with impaired contractile function. An unrecognized but common cause of incontinence in elderly patients.
N. Resnick (1987)
Age related urodynamic changes in patients with benign prostatic hyperplasia.
S. Madersbacher (1996)

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S. Bromage (2010)
Aging effects on contractility of longitudinal and circular detrusor and trigone of rat bladder.
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H. Kakizaki (2000)
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Alan P. Gehrich (2007)
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P. Pavlica (2006)
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Priv. Doz. Dr. med M. Oelke (2012)
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A. Wiedemann (2007)
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A. Hershkovitz (2002)
Detrusor underactivity: Pathophysiological considerations, models and proposals for future research. ICI‐RS 2013
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Urodynamic studies in the surgical treatment of benign prostatic hyperplasia.
M. L. de Lima (2003)
An overview of stress urinary incontinence treatment in women
A. Papatsoris (2007)
Handout W 8 Detrusor underactivity : detection and diagnosis
Matthias Oelke (2015)
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K. Andersson (2014)
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R. Berges (2010)
Effect of chronic ischemia on bladder structure and function.
K. Azadzoi (2003)
Frailty, aging, and incontinence in the elderly : an interactive case-based discussion of best practices
Thomas Griebling (2011)
Pelvic Ultrasound Evaluation for Benign Prostatic Hyperplasia: Prediction of Obstruction
D. Rukstalis (2014)
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R. Bauer (2013)
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N. Yoshimura (2012)
Urodynamische Phänomene der alternden Blase
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Analysis of early morbidity and functional outcome of thulium: yttrium-aluminum-garnet laser enucleation for benign prostate enlargement: patient age and prostate size determine adverse surgical outcome.
S. Rausch (2015)
The Biology of Aging and the Development of Lower Urinary Tract Dysfunction and Disease
J. Macoska (2014)
Uniaxial mechanical behavior of the human female bladder
P. Martins (2011)
Underactive and overactive bladders are related to motor function and quality of life in Parkinson’s disease
Z. Liu (2015)
Detrusor expulsive strength is preserved, but responsiveness to bladder filling and urinary sensitivity is diminished in the aging mouse.
Phillip P Smith (2012)
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S. Halligan (2003)
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Catherine E. DuBeau (2010)
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M. Pons (2005)
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