Detrusor after contractions in men with lower urinary tract symptoms: Myth or reality?

OBJECTIVES To study after contractions in men with lower urinary tract symptoms (LUTS) related to bladder outlet obstruction (BOO), in the absence of neuropathy, and to verify whether it is associated with the severity of symptoms or certain filling and voiding variables. PATIENTS AND METHODS Of 380 patients with LUTS and who were assessed using urodynamic studies, we retrospectively analysed those who had after contractions (ACs). Bladder overactivity was diagnosed as any increase in the detrusor pressure of <2-s duration during the filling phase, and an AC was diagnosed as any increase in the detrusor pressure of ⩾2 s after the end of the voiding phase and complete cessation of flow. The presence of ACs was then assessed in relation to different components of the International Prostate Symptom Score (IPSS), using a two-tailed Levene's test, and to filling and voiding cystometry variables, using Mann-Whitney-Wilcoxon Rank test. RESULTS In all, 373 of the 380 patients were included (seven had invalid voiding cystometry); ACs were detected in 51 (13.9%). There was no statistical significance for associations between AC and any of the variables assessed, including individual questions of the IPSS, detrusor overactivity, cystometric capacity, compliance, maximum urinary flow rate (Qmax), detrusor pressure at Qmax or the maximum detrusor voiding pressure. CONCLUSION ACs detected on voiding cystometry of men with LUTS attributed to BOO do not seem to be related to symptoms, or filling and voiding variables.