Learned voiding dysfunction (non-neurogenic, neurogenic bladder) among adults. 2001

A Groutz, and J G Blaivas, and C Pies, and A M Sassone
Weill Medical College, Cornell University, New York, New York, USA.

Data concerning learned voiding dysfunction (Hinman syndrome; non-neurogenic, neurogenic bladder) in adults are scarce. The present study was conducted to assess the pre-valence and clinical characteristics of this dysfunction among adults referred for evaluation of lower urinary tract symptoms. Learned voiding dysfunction was suggested by a characteristic clinical history and intermittent "free" uroflow pattern and by the absence of any detectable neurological abnormality or anatomic urethral obstruction. A definitive diagnosis was made by the demonstration of typical external urethral sphincter contractions during micturition by EMG or fluoroscopy. A urodynamic database of 1,015 consecutive adults was reviewed. Twenty-one (2%) patients (age, 24-76 years) met our strict criteria of learned voiding dysfunction. Obstructive symptoms were the most common presenting symptoms, followed by frequency, nocturia, and urgency. Eight (35%) patients had recurrent urinary tract infections, seven of these being women. None of the patients had any clinically significant upper urinary tract damage. First sensation volume was significantly lower in women than in men. Both detrusor pressure at maximum flow and maximum detrusor pressure during voiding were found to be significantly higher in men than in women. Further differentiation between adult women and men failed to reveal any other clinically significant differences. In conclusion, by strict video-urodynamic criteria, 2% of our patients had learned voiding dysfunction. Other patients, with presumed learned voiding dysfunction, who did not undergo video-urodynamics were not included in the present series. Thus, the prevalence of learned voiding dysfunction among adults referred for evaluation of lower urinary tract symptoms is likely to be even higher.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009119 Muscle Contraction A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. Inotropism,Muscular Contraction,Contraction, Muscle,Contraction, Muscular,Contractions, Muscle,Contractions, Muscular,Inotropisms,Muscle Contractions,Muscular Contractions
D009518 New York State bounded on the north by Lake Ontario and Canada, on the east by Vermont, Massachusetts, and Connecticut, on the south by the Atlantic Ocean, New Jersey, and Pennsylvania, and on the west by Pennsylvania, Lake Erie, and Canada.
D001750 Urinary Bladder, Neurogenic Dysfunction of the URINARY BLADDER due to disease of the central or peripheral nervous system pathways involved in the control of URINATION. This is often associated with SPINAL CORD DISEASES, but may also be caused by BRAIN DISEASES or PERIPHERAL NERVE DISEASES. Bladder Disorder, Neurogenic,Neurogenic Bladder,Bladder Neurogenesis,Bladder, Neurogenic,Neurogenic Bladder Disorder,Neurogenic Bladder, Atonic,Neurogenic Bladder, Spastic,Neurogenic Bladder, Uninhibited,Neurogenic Dysfunction of the Urinary Bladder,Neurogenic Urinary Bladder Disorder,Neurogenic Urinary Bladder, Atonic,Neurogenic Urinary Bladder, Spastic,Neurogenic Urinary Bladder, Uninhibited,Neuropathic Bladder,Urinary Bladder Disorder, Neurogenic,Urinary Bladder Neurogenesis,Urinary Bladder Neurogenic Dysfunction,Atonic Neurogenic Bladder,Neurogenesis, Bladder,Neurogenesis, Urinary Bladder,Neurogenic Bladder Disorders,Neurogenic Urinary Bladder,Spastic Neurogenic Bladder,Uninhibited Neurogenic Bladder
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly

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