Diagnosis of Urination Disorders in Young Patients with Lower Urinary Tract Symptoms of Uncertain Origin

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Oleh Nikitin
Hennadii Reznikov
Yurii Roshchyn
Viktor Hrytsai
Sergiy Tkachenko

Abstract

Lower urinary tract symptoms (LUTS) are not uncommon in young men. The etiology of LUTS in men aged up to 50 years is diverse. According to various authors, it is recommended to use a complex urodynamics tests (CUT) to assess LUTS in young men. However, even in modern urological practice, many such patients continue to be treated empirically, and the use of urodynamic studies is still not widely practiced for this group.


The objective: assess the clinical significance of CUT in men with LUTS under the age of 50 years.


Materials and methods. The results of CUM in patients with LUTS under the age of 50 were evaluated. 87 patients aged 18 to 43 years with LUTS of uncertain origin were examined.


Results. The leading diagnoses, with which patients were referred, were chronic prostatitis and neurogenic bladder, which were found in 28 (32.2%) and 22 (25.3%) patients, respectively. 21 (24.1%) patients admitted to the clinic had no primary diagnosis. As a result of the examination, infravesical obstruction (IVO) was found in 32 (36.8%) men, hyperactive bladder in 24 (27.6%), hypoactive bladder in 9 (10.3%) patients, non-neurogenic neurogenic bladder – in 7 (8.0%) and 15 (17.2%) men urological pathology was not detected.


Conclusions. We have shown the effectiveness of CUT to clarify the diagnosis in young men under the age of 50 with LUTS. Diagnosed with a significant proportion of patients, urinary disorders have characteristic differences, reflecting the abnormalities found when using CUT. In most patients, the clinical diagnosis was changed after performing CUT. Thus, the use of CUT in young men with LUTS is crucial for a more accurate diagnosis and, therefore, for adequate therapy.

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Section
Urology
Author Biographies

Oleh Nikitin, Bogomolets National Medical University

Oleh D. Nikitin,

Department of Urology

Hennadii Reznikov, Donetsk National Medical University of of the Ministry of Health of Ukraine

Hennadii D. Reznikov,

Department of Urology

Yurii Roshchyn, Donetsk National Medical University of of the Ministry of Health of Ukraine

Yurii V. Roshchyn,

Department of Urology

Viktor Hrytsai, Bogomolets National Medical University

Viktor S. Hrytsai,

Department of Urology

Sergiy Tkachenko, Donetsk National Medical University of of the Ministry of Health of Ukraine

Sergiy V. Tkachenko,

Department of Urology

References

Van Koeveringe GA, Vahabi B, Andersson KE, Kirschner-Herrmans R, Oelke M. Detrusor underactivity: A plea for new approaches to a common bladder dysfunction. Neurourol Urodyn. 2011 Jun;30(5):723–8. Available from: https://pubmed.ncbi.nlm.nih.gov/21661020/ DOI: 10.1002/nau.21097

Kaplan SA, Te AE, Jacobs BZ. Urodynamic evidence of vesical neck obstruction in men with misdiagnosed chronic nonbacterial prostatitis and the therapeutic role of endoscopic incision of the bladder neck. J Urol. 1994 Dec;152(6 Pt 1):2063–5. Available from: https://pubmed.ncbi.nlm.nih.gov/7966675/ DOI: 10.1016/s0022-5347(17)32309-1

Mishra VK, Kumar A, Kapoor R, Srivastava A, Bhandari M. Functional bladder neck obstruction in males: a progressive disorder? Eur Urol. 1992;22(2):123–9. Available from: https://pubmed.ncbi.nlm.nih.gov/1478227/ DOI:10.1159/000474738

Gratzke C, Bachmann A, Descazeaud A, Drake MJ, Madersbacher S, Mamoulakis C et al. EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction. Eur Urol. 2015 Jun;67(6):1099–1109. Available from: https://pubmed.ncbi.nlm.nih.gov/25613154/ DOI: 10.1016/j.eururo.2014.12.038. Epub 2015 Jan 19

Donohoe JM, Combs AJ, Glassberg KI. Primary bladder neck dysfunction in children and adolescents II: results of treatment with α-adrenergic antagonists. J Urol. 2005 Jan;173(1):212–6. Available from: https://pubmed.ncbi.nlm.nih.gov/15592078/ DOI: 10.1097/01.ju.0000135735.49099.8c.

Toh K-L, Ng C-K. Urodynamic studies in the evaluation of young men presenting with lower urinary tract symptoms. Int J Urol. 2006 May;13(5):520–3. Available from: https://pubmed.ncbi.nlm.nih.gov/16771719/ DOI: 10.1111/j.1442-2042.2006.01347.x

Nickel JC. Prostatitis: myths and realities. Urology. 1998 Mar;51(3):362–6. Available from: https://pubmed.ncbi.nlm.nih.gov/9510337/ DOI: 10.1016/s0090-4295(97)00643-2

Yalla SV, Blute RD, Snyder H, Yap W, Fraser L, Friedman E. Isolated bladder neck obstruction of undetermined etiology (primary) in adult male: recognition and management. Urology. 1981 Jan;17(1):99–108. Available from: https://pubmed.ncbi.nlm.nih.gov/7456212/ DOI: 10.1016/0090-4295(81)90027-3