[Mechanical changes of the detrusor after antiincontinence surgery]. 2004

Luis Eduardo Romero Nava, and María del Pilar Velázquez Sánchez, and Jorge Ralf Kunhardt Rasch
Instituto Nacional de Perinatología. lern17@hotmail.com

BACKGROUND Stress urinary incontinence is secondary to an intrinsic defect in the closure or a lack of urethral support; the treatment is surgical and this may affect vesical voiding by creating an obstruction, modifying the contraction power at opening and the mechanical properties of the detrusor. OBJECTIVE To know if there are changes in the contractile characteristics of the detrusor in order to maintain an efficient voiding after surgical correction of the urinary incontinence. METHODS This was a cohort study of the urodynamic variables, mechanical work and energy of the detrusor, during cystometric and pressure-flow analysis, before and after antiincontinence surgery. Forty-five patients were included with urodynamic study before surgery and another one between 6 weeks and 6 months. We analyzed these data using student T test and ANOVA. RESULTS The average and maximum flow rates, voiding efficient and velocity of the detrusor decreased. The pressures of the detrusor, the opening power and energy increased significantly after the surgery. These changes were more important in the Burch group. The 24.4% of the patients presented de novo hyperactive bladder; before surgery these patients had detrusor's pressures, voiding power and energy significantly greater. CONCLUSIONS There are changes in the mechanical properties of the detrusor after antiincontinence surgery; the detrusor needs a greater energy output to defeat urethral resistance and to maintain the vesical voiding, these were better in patients with Burch procedure and with overactive bladder.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
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
D014550 Urinary Incontinence, Stress Involuntary discharge of URINE as a result of physical activities that increase abdominal pressure on the URINARY BLADDER without detrusor contraction or overdistended bladder. The subtypes are classified by the degree of leakage, descent and opening of the bladder neck and URETHRA without bladder contraction, and sphincter deficiency. Urinary Stress Incontinence,Incontinence, Urinary Stress,Stress Incontinence, Urinary
D014563 Urodynamics The mechanical laws of fluid dynamics as they apply to urine transport. Urodynamic
D015331 Cohort Studies Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. Birth Cohort Studies,Birth Cohort Study,Closed Cohort Studies,Cohort Analysis,Concurrent Studies,Historical Cohort Studies,Incidence Studies,Analysis, Cohort,Cohort Studies, Closed,Cohort Studies, Historical,Studies, Closed Cohort,Studies, Concurrent,Studies, Historical Cohort,Analyses, Cohort,Closed Cohort Study,Cohort Analyses,Cohort Studies, Birth,Cohort Study,Cohort Study, Birth,Cohort Study, Closed,Cohort Study, Historical,Concurrent Study,Historical Cohort Study,Incidence Study,Studies, Birth Cohort,Studies, Cohort,Studies, Incidence,Study, Birth Cohort,Study, Closed Cohort,Study, Cohort,Study, Concurrent,Study, Historical Cohort,Study, Incidence
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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