ISSN: 2578-4676
Authors: Palleschi G*, Cardi A and Rossi V
Urodynamics is the more accurate diagnostic tool to assess functional alterations of lower urinary tract. International guidelines provide specific indications to adopt this test for the evaluation algorithm of patients with lower urinary tract symptoms. Although recent innovations in diagnostic methodologies, especially regarding ultrasounds, have reduced the use of urodynamics compared to the past, this procedure retains its importance in specific conditions, such as in patients with neurogenic lower urinary tract dysfunction, when symptoms do not improve after first line therapeutic approaches, especially in cases of complicated urinary incontinence and bladder outlet obstruction. Among patients’ cathegories who are often requested to provide urodynamic data are those undergoing hemodialysis. In these subjects urinary symptoms often develop reducing quality of life and increasing the risk of severe sistemic complications. Furthermore, bladder outlet obstruction and other alterations that increase the risk of vesico-ureteral refluxes and chronic urinary retention have to be excluded before a kidney transplant. Urodynamics can properly assess lower urinary tract dysfunction of patients undergoing hemodialysis, who are often oliguric and anuric, and therefore suffering for bladder atrophy with impaired function. This alteration is frequently responsible for recurrent inflammatory disorders of the lower urinary tract. Considering these aspects and lack of data provided by Literature on this topic, aim of this study was to assess the prevalence of lower urinary tract symptoms in a cohort of patients undergoing hemodialysis and to investigate their urodynamic findings. The results show that lower urinary tract symptoms are prevalent in patients attending our hemodialysis center, being inflammatory disorders the most represented as a consequence of bacterial urinary tract infections. Lower urinary tract symptoms, especially urinary burning, frequency, urgency and nocturia, resulted to be the third reason for seeking medical assistance by patients, following cardiovascular and respiratory symptoms. Urodynamics showed in all patients a reduced cystometric capacity, often associated with reduced compliance and detrusor overactivity; pressure / flow studies provided evidence either of bladder outlet obstruction and underactive detrusor.
Keywords: Urodynamic; Urinary; Patients; Symptoms
