Gait analysis of young male patients diagnosed with primary bladder neck obstruction |
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| Institution: | 1. Dpt. of Biomedical Sciences for Health, Università degli Studi di Milano, via Mangiagalli 31, 20133 Milano, Italy;2. Current address: Dept. of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milano, Italy;1. School of Physical Education, Physical Therapy and Occupational Therapy, Department of Sports, Federal University of Minas Gerais – UFMG, Belo Horizonte, Minas Gerais, Brazil;2. Sports Center, Federal University of Ouro Preto – UFOP, Ouro Preto, Minas Gerais, Brazil;3. Laboratory of Movement Analysis and Exercise Physiology of the Biomedical Engineering Program, Institute for Graduate Studies and Research in Engineering (COPPE), Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;4. School of Engineering, Department of Mechanical Engineering, Federal University of Minas Gerais – UFMG, Belo Horizonte, Minas Gerais, Brazil;1. English Institute of Sport, Manchester, United Kingdom;2. Department of Sport, Exercise and Rehabilitation, Northumbria University, United Kingdom;3. Golf College, Dunchy College, Cornwall, United Kingdom;4. Water Research Group, North West University, Potchefstroom, South Africa;1. Department of Urology, SS Annunziata Hospital, “G.D''Annunzio” University of Chieti, Chieti, Italy;2. Department of Urology, ASL Abruzzo 2, Chieti, Italy;3. Department of Urology, University Hospitals, Case Western Reserve University, Cleveland, OH;4. Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “L. Vanvitelli”, Naples, Italy;1. Department of Urology, Ruppiner Kliniken, Brandenburg Medical School, Neuruppin, Germany;2. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;3. Department of Urology, St. Elisabeth-Klinikum, Straubing, Germany;1. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden;2. School of Biomedical Sciences, University of Queensland, Brisbane, Australia;3. School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia |
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| Abstract: | Primary bladder neck obstruction (PBNO) represents an inappropriate or inadequate relaxation of the bladder neck during micturition. Based on the observation of an increased rate of postural imbalances in male patients with PBNO, we hypothesized a possible role of an unbalanced biomechanics of the pelvis on urethral sphincters activity. Our aim was to identify kinematic imbalances, usually disregarded in PBNO patients, and which could eventually be involved in the etiopathogenesis of the disease.Seven male adult patients (39.6 ± 7.1 years) were recruited; in all patients, PBNO was suspected at bladder diary and uroflowmetry, and was endoscopically confirmed with urethroscopy. Participants gait was recorded with a motion capture system (BTS Spa, Italy) to obtain three-dimensional joint angles and gait parameters. Multivariate statistics based on a Principal Component model allowed to assess the similarity of patients’ gait patterns with respect to control subjects.The main finding is that patients with PBNO showed significant discordance in the observations at the ankle and pelvis level. Additionally, 6/7 patients demonstrated altered trunk positions compared to normal curves. We suggest that the identified postural imbalances could represent the cause for an anomalous activation of pelvic floor muscles (hypertonia). The consequent urinary sphincters hypercontraction may be responsible for the development of voiding dysfunction in male patients with no significant morphological alterations.Results reinforced the hypothesis of an etiopathogenetic role of postural imbalances on primary bladder neck obstruction in male patients. |
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| Keywords: | Urology Voiding dysfunction Lower urinary tract symptoms Postural control Pelvic imbalances |
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