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. 2021 Sep 1;27(9):e639-e644.
doi: 10.1097/SPV.0000000000001035.

Is Nocturia Associated With Detrusor Underactivity?

Hannah T Ryles  1 , Stephanie A Sansone  2 , Pamela J Levin  1 , Uduak U Andy  1 , Heidi S Harvie  1 , Lily A Arya  1
Affiliations

Is Nocturia Associated With Detrusor Underactivity?

Hannah T Ryles et al. Female Pelvic Med Reconstr Surg. .

Abstract

Objectives: Detrusor underactivity (DU) is diagnosed using urodynamic testing. We hypothesized that nocturia is associated with detrusor underactivity.

Methods: We performed a retrospective chart review of all women who underwent urodynamic testing at our institution between 2016 and 2018. Uroflowmetry and pressure-flow study parameters were compared between women with nocturia (≥2 voids/night) and without nocturia (0-1 void/night). Detrusor underactivity was diagnosed using 3 different criteria: (1) bladder voiding efficiency (BVE) of <90%, (2) bladder contractility index of <100, and (3) a composite of three urodynamic measures (Gammie criteria).

Results: Of 358 women, 172 (48%) were in the nocturia group and 186 (52%) were in the no nocturia group. On uroflowmetry, median postvoid residual volume was similar (20 mL) in both groups. Median maximum flow rate (15 vs 17 mL/s, P < 0.05) and average flow rate (6 mL/s vs 7 mL/s, P < 0.05) were significantly lower in the nocturia group compared with the no nocturia group. During pressure-flow study, a significantly greater proportion of women with nocturia were unable to void around the catheter (30% vs 27%, P < 0.01). The overall rate of DU varied with the criteria used: BVE (54%), bladder contractility index (41%), and Gammie criteria (7%). The rate of DU using the BVE criteria was significantly higher in the nocturia group (63% vs 48%, P < 0.01), but no significant differences were noted using the other criteria.

Conclusions: Nocturia is associated with reduced voiding efficiency in women. The diagnosis of DU using urodynamics is challenging.

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Figures

Figure 1.
Figure 1.. Rates of detrusor underactivity by three different criteria of all 274 patients analyzed with pressure flow data.
CURE-UAB: Bladder voiding efficiency (BVE) < 90% BCI (Hoag & Gani): Bladder contractility index (BCI) < 100 with absence of identified bladder outlet obstruction Gammie: PdetQmax < 20 cmH2O + Qmax < 15 mL/s + BVE < 90%
See this image and copyright information in PMC

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