Clinical Implication of DAC (Detrusor After-contraction) (DAC)

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

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

Study Overview

• Status: Completed
• Conditions: Voiding Dysfunction

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 2309

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of, 110-744
    • Seoul National University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

2,309 patients more than 18 years old with neurogenic or non-neurogenic voiding dysfunction who performed urodynamic studies

Description

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

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
DAC group; patients who show detrusor after-contraction during voiding cystometrography (CMG)

What is the study measuring?

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)

Collaborators and Investigators

• Sponsor: Seoul National University Hospital
• Investigators: Principal Investigator: Seung-June Oh, M.D.,Ph.D., Seoul National University Hospital

Publications and helpful links

General Publications

• Ruarte AC, Podesta ML, Medel R. Detrusor after-contractions in children with normal urinary tracts. BJU Int. 2002 Aug;90(3):286-93. doi: 10.1046/j.1464-410x.2002.02827.x.

Study record dates

Study Major Dates

• Study Start: January 1, 2007
• Primary Completion (Actual): December 1, 2008
• Study Completion (Actual): December 1, 2008

Study Registration Dates

• First Submitted: June 29, 2010
• First Submitted That Met QC Criteria: June 30, 2010
• First Posted (Estimate): July 1, 2010

Study Record Updates

• Last Update Posted (Estimate): July 1, 2010
• Last Update Submitted That Met QC Criteria: June 30, 2010
• Last Verified: June 1, 2010

More Information

Terms related to this study

• Keywords: LUTS; bladder dysfunction; urodynamic; detrusor after-contraction; urinary bladder, overactive
• Other Study ID Numbers: DAC; H-0805-056-245