Malone-Lee, James Gerard; (1991) The characterisation of the urodynamics of elderly people with lower urinary tract dysfunction. Doctoral thesis (M.D), UCL (University College London).

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Abstract

This thesis examined the age-related differences in the urodynamics of men and women presenting with symptoms of lower urinary tract dysfunction. In order to characterise the nature of the differences as precisely as possible the urodynamic data were analysed according to mechanically based mathematical principles derived by a number of physicists working the field. I developed a set of computer programmes which were used to collect and process the data. In addition, I constructed a computerised mathematical model of the micturition process which was used to illustrate the theory behind my approach to analysis as well as to aid in the interpretation of the data. A very large sample was used (2393 patients) so that age-related changes could be examined across the four decades of late life. Important differences were found, the most striking findings concerned voiding abilities which seemed to be markedly compromised in the elderly because of problems in sustaining micturition and reductions in the speed of detrusor shortening. Elderly men were found to show fewer differences from their younger counterparts, than those shown by women. Many of the changes, similar to those seen in the elderly, were found to occur in a number of important illnesses which affect both the young and the old. A number of assumptions made about the elderly were refuted and I obtained data which contradicted the findings of some other workers in the field.

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