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Int Neurourol J > Accepted Articles
DOI: https://doi.org/10.5213/inj.2040468.234    [Accepted]
Risk Factors Predicting Upper Urinary Tract Damage in Patients With Myelodysplasia: Data Analysis of 637 Cases From a Single Center
Han Deng1,2,3, Zhaoxia Wang4, Limin Liao1,2,3, Juan Wu1,2, Yue Wang1,2
1Department of Urology, China Rehabilitation Research Center, Rehabilitation School of Capital Medical University, Beijing, China
2Department of Urology, Capital Medical University, Beijing, China
3University of Rehabilitation, Qingdao, China
4Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Correspondence  Limin Liao ,Email: lmliao@263.net
Submitted: 16 December 2020;  Accepted after revision: 8 February 2021.
ABSTRACT
Purpose
To determine the risk factors predicting upper urinary tract (UUT) damage using a grading system for upper urinary tract dilation (UUTD) and a descriptive system for all urinary tract dysfunction (AUTD) in patients with myelodysplasia.
Methods
Six hundred thirty-seven patients with myelodysplasia were evaluated at our center from January 2008 to November 2019. Clinical data, ultrasonography, magnetic resonance urography (MRU), and video-urodynamics (VUDS) parameters were collected. Univariate and multivariate analyses were used to determine the risk factors predicting UUT damage.
Results
Three hundred eighty-three males and 254 females were included. The average course of lower urinary tract symptoms (LUTS) was 14.08±7.07 years (range, 3-31 years). The urodynamic diagnoses of all patients were as follows: detrusor overactivity (DO), 26.8%; detrusor underactivity (DU), 6.44%; and acontractile detrusor (AcD), 66.72%%. UUT damage was determined in 66.56% of the patients. Of the patients, 28.73 % had vesicoureteral reflux (VUR) during filling (bilateral, n=50; unilateral, n=133) on fluoroscopy during VUDS testing. Two hundred thirty-four patients had UUTD (bilateral, n=203; unilateral, n=31). The occurrence of hydronephrosis based on ultrasonography was closely related to ipsilateral VUR (P<0.05). Absent of bladder sensation, long-term course of LUTS, decreased maximum cystometric capacity (MCC) and bladder compliance (BC), and increased post-void residual urine (PVR) were shown to be independent risk factors in logistic regression analysis.
Conclusions
This retrospective study using UUTD and AUTD systems indicated that patients with myelodysplasia have a high incidence of UUT damage. Absence of bladder sensation, long-term course of LUTS, decreased MCC and BC, and increased PVR were independent risk factors predicting UUT damage.
Keywords: Myelodysplasia; Upper urinary tract damage; Video-urodynamics
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Official Journal of Korean Continence Society & ESSIC (International Society for the Study of BPS) & Korean Society of Urological Research & The Korean Children’s Continence and Enuresis Society & The Korean Association of Urogenital Tract Infection and Inflammation & Korean Society of Geriatric Urological Care
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