Korean J Urol.  2006 Feb;47(2):165-170. 10.4111/kju.2006.47.2.165.

Urodynamic Analysis of Taxi Drivers with Lower Urinary Tract Symptoms

Affiliations
  • 1Department of Urology, College of Medicine, Catholic University of Daegu, Daegu, Korea. dykim@cu.ac.kr

Abstract

PURPOSE: Lower urinary tract symptoms (LUTS) in taxi drivers may be associated with many years of driving or bad voiding habits such as excessive inhibition of voiding and repetitive bladder over-distension. This condition may be treated under the false impression that the patient is suffering with benign prostatic hyperplasia or prostatitis. In this study, the urodynamic data of taxi drivers with LUTS were analyzed according to the storage and voiding symptom results.
MATERIALS AND METHODS
45 patients who underwent urodynamic study were included in this study among all the taxi drivers who complained of LUTS and who were without benign prostatic hyperplasia, urethritis and a prostatitis history. All the patients took the International Prostate Symptom Score (IPSS) self-assessment test. We divided the patients into 2 groups according to the chief complaint of storage symptoms (group I, 21 cases) and voiding symptoms (group II, 24 cases). The age distribution, driving years and prostate size were similar between the 2 groups.
RESULTS
The IPSS were 14.47+/-4.82 in group I and 13.91+/-3.49 in group II. Group II had larger maximal cystometric capacity than did group I (p<0.05). 4 cases of idiopathic detrusor overactivity (IDO) were observed in group I (p<5). Group II had a lower mean maximal flow rate than group I (p<0.05). The post-voiding residual urine volume and detrussor pressure at maximal flow were similar between the groups. There were 17 cases of pseudo-detrusor-sphicter dyssynergia observed in group II and 7 cases observed in group I (p<5). Detrusor underactivity (DU) was observed in 3 patients of group II.
CONCLUSIONS
There were abnormal findings such as IDO, bladder outlet obstruction (BOO) and DU on the urodynamic studies of the taxi drivers. IPSS is insufficient for the diagnosis of BOO and DU. Urodynamic study may be useful in establishing the correct diagnosis and treatment of taxi drivers.

Keyword

Urinary tract; Symptoms; Urodynamics

MeSH Terms

Age Distribution
Ataxia
Diagnosis
Humans
Lower Urinary Tract Symptoms*
Prostate
Prostatic Hyperplasia
Prostatitis
Self-Assessment
Urethritis
Urinary Bladder
Urinary Bladder Neck Obstruction
Urinary Tract
Urodynamics*

Reference

1. Chute CG, Panser LA, Girman CJ, Oesterling JE, Guess HA, Jacobsen SJ, et al. The prevalence of prostatism: a population-based survey of urinary symptoms. J Urol. 1993. 150:85–89.
2. Abrams PH, Feneley RC. The significance of the symptoms associated with bladder outflow obstruction. Urol Int. 1978. 33:171–174.
3. Kuo HC. Pathophysiology of lower urinary tract symptoms in aged men without bladder outlet obstruction. Urol Int. 2000. 64:86–92.
4. 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 bladder neck. J Urol. 1994. 152:2063–2065.
5. Mishra VK, Kumar A, Kapoor R, Srivastava A, Bhandari M. Functional bladder neck obstruction in males; a progressive disorder? Eur Urol. 1992. 22:123–129.
6. Blaivas JG. Urodynamic diagnosis of primary bladder neck obstruction. World J Urol. 1984. 2:191–195.
7. Oh KJ, Oh BR, Ryu SB. A study for the development of prostate associated urinary tract symptoms in occupational taxi drivers. Korean J Urol. 2004. 45:125–129.
8. Kim YS, Choi YD, Kang KH, Ryu RH, Choi HK, Park HS, et al. Study of prostatic disease and symptom between special occupation groups (Taxi Driver, Barber). Korean J Urol. 1998. 39:1093–1097.
9. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract dysfunction: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002. 21:167–178.
10. Bae US, Kim KB. Normogram in asymptomatic elderly males. Korean J Urol. 1994. 35:283–288.
11. Van Msatrigt R, Rollema HJ. The prognostic value of bladder contractility in transurethral resection of the prostate. J Urol. 1992. 148:1856–1860.
12. Krogh J, Beuke HP, Christensen AB, Sparso BH. Long term results of bladder neck incision in men. Urol Int. 1991. 46:55–57.
13. Andersen JT, Nordling J, Meyhoff HH, Jacobsen O, Hald T. Functional bladder neck obstruction. Late results after endoscopic bladder neck incision. Scand J Urol Nephrol. 1980. 14:17–22.
14. Delaere KP, Debruyne FM, Moonen WA. Extended bladder neck incision for outflow obstruction in male patients. Br J Urol. 1983. 55:225–228.
15. Hellstrom WJ, Schmidt RA, Lue TF, Tanagho EA. Neuromuscular dysfunction in nonbacterial prostatitis. Urology. 1987. 30:183–186.
16. Salimpour P, Doursounian M, Cantey-Kieser J, Adelstein M, Gholami SS, Wen CC, et al. Sexual and urinary tract dysfunction in bicyclists. J Urol. 1998. 159:Suppl. 30A. abstract 116.
17. Crowe R, Noble J, Robson T, Soediono EJ, Milroy EJ, Burnstock G. An increase of neuropeptide Y but not nitric oxide synthase-immunoreactive nerves in the bladder neck from male patients with bladder neck dyssynergia. J Urol. 1995. 154:1231–1236.
18. Matzkin H, Greenstein A, Prager-Geller T, Sofer M, Braf Z. Do reported micturition symptoms on the American Urological Association Questionnaire correlate with 24-hour home uroflowmetry recordings? J Urol. 1996. 155:197–199.
19. Chai TC, Belville WD, McGuire EJ, Nyquist L. Specificity of the American Urological Association voiding symptom index: comparison of unselected and selected samples of both sexes. J Urol. 1993. 150:1710–1713.
20. Lepor H, Machi G. Comparison of the AUA symptom index in unselected males and females between 55 and 79 years of age. Urology. 1993. 42:36–40.
21. Jolleys JV, Jolleys JC, Willson J, Donovan J, Nanchamel K, Abrams P. Does sexual quality to urinary symptoms? Neurourol Urodyn. 1993. 12:391–392.
22. Ko DS, Fenster HN, Chambers K, Sullivan LD, Jens M, Goldenberg SL. The correlation of multichannel urodynamic pressure-flow studies and American Urological Association symptom index in the evaluation of benign prostatic hyperplasia. J Urol. 1995. 154:396–398.
23. Kaplan SA, Bowers DL, Te AE, Olsson CA. Differential diagnosis of prostatism: a 12-year retrospective analysis of symptoms, urodynamics and satisfaction with therapy. J Urol. 1996. 155:1305–1308.
24. Kim HJ, Kim SS, Park HS, Lee JG. Urodynamic analysis of men with lower urinary tract symptoms without benign prostatic hyperplasia. Korean J Urol. 2002. 43:231–236.
25. Webster GD, Lockhart JL, Older RA. The evaluation of bladder neck dysfunction. J Urol. 1980. 123:196–198.
26. Norlen LJ, Blaivas JG. Unsuspected proximal urethral obstruction in young and middle aged men. J Urol. 1986. 135:972–976.
27. McGuire EJ. Bladder compliance. J Urol. 1994. 151:965–966.
28. Sung DJ, Kim JJ, Lee JG. Urodynamic analysis of the functional voiding disorders in young adult. Korean J Urol. 1996. 37:441–448.
29. Levin RM, High J, Wein AJ. Metabolic and contractile effects of anoxia on the rabbit urinary bladder. J Urol. 1982. 128:194–196.
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