Will detrusor acontractility recover after medical or surgical treatment? A longitudinal long‐term urodynamic follow‐up

Aims Patients with urinary retention due to detrusor acontractility (DA) might regain voiding efficiency (VE) after treatment. This study investigated the long‐term outcomes and predictors of recovery following treatment. Methods A total of 32 patients with DA were retrospectively identified and enrolled. DA was defined by Pdet.Qmax = 0 cmH2O and postvoid residual (PVR) > 300 ml determined through videourodynamic study (VUDS). All patients received medical or surgical treatment and were followed up for at least 3 months, during which repeat VUDS was conducted. Detrusor contractility recovery was confirmed when patients were able to void with a Pdet.Qmax ≥ 10 cmH2O after treatment. Results Our patients comprised 22 women and 10 men (mean age, 73.2 ± 9.7 years; mean follow‐up duration, 1.6 ± 1.8 [0.3–7.4] years). Follow‐up VUDS revealed that 14 (43.9%) patients recovered from detrusor contractility, with five patients recovering within 1 year and nine after 1 year. Pdet.Qmax, voided volume, PVR, maximum flow rate, and VE significantly improved in both the recovery and nonrecovery groups. The recovery group had significantly better VE (p = .039) and significantly lower bladder compliance (74.2 ± 83.2 vs. 119 ± 82.6; p = .007) than the nonrecovery group. Receiver operating characteristic (ROC) analysis revealed an optimum bladder compliance cutoff value of