Clinical Implication of DAC (Detrusor After-contraction)

Study Overview
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Brief Summary
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The aims of this study are to confirm whether detrusor after-contraction (DAC) is a true contraction or not with a new approach and to understand clinical implication of DAC

Detailed Description
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The definition of detrusor after-contraction (DAC) is usually accepted as the increase of detrusor pressure (Pdet), whether it is sudden or not, after cessation of urinary flow. The amount of increase in Pdet is sometimes included in the definition of DAC (14, 15, 20 cmH2O or at least two times the level of the maximal Pdet during the voiding phase). However, it is clear that the lack of a well-established definition may induce much bias in the interpretation of the clinical implication of DAC. The previous studies showed a wide range of prevalence.1-4 DAC seemed to occur more frequently in children and the occurrence rate usually decreased with age in urodynamic studies.

Official Title
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A New Approach to Clinical Implication of Detrusor After-contraction (DAC)

Conditions
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Voiding Dysfunction

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Indications and selection of patients for conduction of urodynamic studies (UDS) were followed as the recommendation of ICS (international continence society). Exclusion Criteria: Patients with indwelling catheters, urinary tract infection and urinary stones were excluded from this study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| DAC group<br>patients who show detrusor after-contraction during voiding cystometrography (CMG) | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| to confirm whether DAC is a true contraction or not | no change of Pdet when patients cough could confirm that DAC was a true contraction. Because an artifact occurred when a catheter was pressed against bladder wall or urethra, no change of intravesical pressure and increase of abdominal pressure finally induced a negative deflection of Pdet and this change of Pdet could be regarded as an artifact. | up to 2 years (2007.Jan-2008.Dec) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Past medical history including neurological disorders and pelvic irradiation were also included in the database | One-way analysis of variance and the chi-square test were performed to determine whether there was a relationship between the presence of DAC and the underlying neurogenic and non-neurogenic conditions | up to 2 years (2007.Jan-2008.Dec) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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detrusor after-contraction, urodynamic, LUTS, urinary bladder, overactive, bladder dysfunction