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PubMed2002

Correlations of urodynamic changes with changes in symptoms and well-being after transurethral resection of the prostate.

PURPOSE: To establish the predictive value of urodynamics on the outcome of transurethral prostate resection for benign prostatic enlargement we correlated urodynamic changes with symptomatic improvement, decreased bother, and increased general well-being and quality of life after transurethral prostate resection. MATERIALS AND METHODS: Men with lower urinary tract symptoms were selected if they met study criteria and underwent tests recommended by the International Scientific Committee on Benign Prostatic Hyperplasia, and if post-void residual urine volume and prostate size were estimated. Patients answered quality of life, symptom index, symptom problem index and benign prostatic hyperplasia impact index questions. Patients also underwent urodynamic evaluation. Men were included in analysis when transurethral prostate resection was selected as the treatment modality. Of the 132 patients included 93 were reevaluated 6 months after transurethral prostate resection. RESULTS: Improvements after transurethral prostate resection were significantly associated with decreased bladder outlet obstruction (p <0.01). However, 32 cases that were unobstructed or equivocal preoperatively also benefited moderately from resection. Effective capacity, that is cystometric capacity minus post-void residual urine volume, increased by an average of 45% postoperatively. The increase in effective capacity contributed to a significant decrease in symptoms and bother, and to improved well-being. Of the men with a urodynamically proved stable bladder 90% maintained a stable bladder after prostatectomy, while in 50% with a urodynamically proved unstable bladder it became stable postoperatively. CONCLUSIONS: Performing urodynamics preoperatively helps to predict the degree of symptom relief, decreased bother and increased well-being after transurethral prostate resection.

Aged↗
PubMed1991

Bladder training in older women with urinary incontinence: relationship between outcome and changes in urodynamic observations.

The purpose of this study was to clarify the mechanism by which bladder training affects urinary incontinence. Urodynamic data and specific urodynamic diagnoses of 108 women with urinary incontinence were compared before and 6 months after treatment with bladder training. Before treatment, 76 women had sphincteric incompetence, 11 had detrusor instability, and 16 had both. After treatment, 33 women no longer fulfilled the urodynamic diagnostic criteria for either sphincter or detrusor dysfunction. Controlling for severity before treatment, the number of incontinent episodes post-treatment was not associated with change in urodynamic diagnosis. Only the first sensation to void, voided volume, compliance, functional urethral length, and flow time showed any significant changes between pre- and post-treatment evaluations; however, none were correlated with change in the number of incontinent episodes. Bladder training does not appear to affect lower tract urodynamic variables or specific urodynamic diagnosis, and it is likely that its mechanism of action reflects adaptive behavioral changes. Physiologic changes not detected with techniques and/or criteria used in this study may still occur.

Aged↗
PubMed2003

Preoperative urodynamic evaluation may predict voiding dysfunction in women undergoing pubovaginal sling.

PURPOSE: We determine which urodynamic parameters can best predict postoperative voiding dysfunction following pubovaginal sling surgery. MATERIALS AND METHODS: The records of 98 consecutive women who had undergone pubovaginal sling surgery with allograft fascia lata between July 1998 and July 2000 were reviewed. Urodynamic and followup data were sufficient for evaluation for 73 patients. Urodynamic and clinical parameters were correlated with urinary retention, time to return of efficient voiding and development of postoperative urgency symptoms. RESULTS: Average time to return of efficient voiding was 3.92 days (median 3). Of 21 women who voided without a detrusor contraction urinary retention developed in 4 (23%) versus 0 of 48 who voided with detrusor contraction (p = 0.007). Urinary retention was defined as the need to perform even occasional self-catheterization. All 4 women with urinary retention had a detrusor pressure of less than 12 cm. H(2)O (0 in 3, 4 in 1). None of the women with a detrusor pressure of greater than 12 cm. H(2)O had urinary retention (p = 0.047). The presence of Valsalva voiding in women without a detrusor contraction did not affect the incidence of urinary retention (11.1%) compared to those who did not demonstrate Valsalva voiding (5.1%) (p = 0.603). Peak flow rate, detrusor instability on preoperative urodynamics and post-void residual urine volume were not associated with postoperative urinary retention. Finally, post-void residual urine volume predicted delayed return to normal voiding (p = 0.001). There were no other urodynamic parameters that were significantly associated with urinary retention, delayed return to normal voiding or postoperative urgency symptoms including peak flow rate, capacity or compliance. CONCLUSIONS: Women who void without or with a weak detrusor contraction are most likely to have urinary retention postoperatively. Therefore, we conclude that preoperative urodynamic evaluation may be used to counsel women regarding the risk of urinary retention following the pubovaginal sling procedure.

Fascia Lata↗
PubMed2005

A comparison of urodynamic diagnoses and detrusor muscle function in white and South Indian Asian women.

PURPOSE: We compared urodynamic data and the final diagnosis after testing between white and Asian women investigated for urinary incontinence. MATERIALS AND METHODS: Urodynamic traces of consecutive women investigated between January 2002 and December 2003 were reviewed. Urodynamic diagnoses were classified as normal, urodynamic stress incontinence, detrusor overactivity (DOA) or mixed incontinence. In DOA cases the amplitude and number of detrusor contractions, and the volume at which the first involuntary contraction occurred were recorded. Data were compared by ethnic group. RESULTS: The distribution of diagnoses was significantly different between Asian and white women (p <0.0001). In Asian and white women we noted urodynamic stress incontinence in 22% and 53% (OR 0.24, 95% CI 0.13 to 0.48), DOA in 28% and 17% (OR 1.88, 95% CI 0.98 to 3.60) and mixed incontinence in 22% and 7% (OR 3.74, 95% CI 1.70 to 8.22), respectively. Post-void residual volume (p = 0.02), volume at strong desire to void (p = 0.03) and cystometric capacity (p = 0.0002) were lower in Asian women. In those with DOA the first contraction occurred at a lower volume in Asian woman (57 vs 179 ml, p = 0.002). Asian women had more contractions (5 vs 3, p = 0.009) with higher maximum (50 vs 32 cm H2O, p = 0.004) and average (34.4 vs 25.3 cm H2O, p = 0.03) detrusor pressure. CONCLUSIONS: In women who undergo urodynamics a greater proportion of Asian women have DOA and mixed incontinence compared with white women. Functional differences in detrusor contraction pressures exist, which may suggest a fundamental difference in bladder function or disease etiology. Exploration of this theory requires further study.

Asian People↗
PubMed2004

Urodynamic findings before and after noninvasive management of bladder calculi.

OBJECTIVES: To determine the most frequent urodynamic observations associated with bladder calculi, and to assess whether the presence of calculi alters these observations. PATIENTS AND METHODS: Fifty patients with bladder stones were included in a prospective study in which two urodynamic tests were used, one at inclusion and another once the patient was stone- free after treatment by noninvasive methods (mainly extracorporeal shockwave lithotripsy). RESULTS: The results from the urodynamic evaluation with the stone in the bladder were: bladder outlet obstruction in 51%, detrusor overactivity in 68%, detrusor under-activity in 10%, and a normal study in 18%. There were no significant differences between the urodynamic study before or after treatment in maximum flow rate and postvoid residual volume, detrusor overactivity and detrusor pressure at maximum flow. CONCLUSIONS: Conversely to what has been accepted for years, bladder calculi are not always associated with bladder outlet obstruction and the urodynamic results are not influenced by the presence of bladder stones during the urodynamic testing.

Aged↗
PubMed1987

Urinary incontinence in elderly women: urodynamic evaluation.

The objective of this study is to characterize urinary incontinence observed in elderly women and to assess the importance of various parameters used to evaluate urinary incontinence. Two hundred consecutive, ambulatory, outpatient, incontinent women 55 years of age and over who were seen at the Continence Program Clinic and completed a medical and urodynamic protocol are included in this paper. After a thorough medical history and a complete physical examination, urodynamic tests were performed. The urodynamic results showed that 77% of incontinent women had an incompetent urethra. Twenty-five percent had a hyperactive bladder, 8% had "other" types, and 7% had a normal study. Comparison of the clinical diagnosis with the actual urodynamic diagnosis for stress incontinence revealed a 78% accuracy and only a 6% false negative. In contrast, a similar comparison for urge incontinence found only 44% accurate and 45% false negative. Analysis of the urodynamic tests revealed that the simple provocative full-bladder stress test was as effective as the radiographic or electronic pressure measurement in detecting incompetent urethra producing stress urinary incontinence. Provocative upright cystometry was helpful in uncovering 33% of hyperactive bladders not provoked in the supine position. Complex urodynamic tests should be reserved for unexplained incontinence or when symptomatology is complex.

Aged↗
PubMed1997

Urodynamic and neurophysiological evaluation in Parkinson's disease and multiple system atrophy.

AIMS: To determine whether Parkinson's disease and multiple system atrophy each has a distinct pattern of micturition abnormalities and whether a urodynamic evaluation could be useful in the differential diagnosis between the two diseases. METHODS: Sixty two patients (30 with Parkinson's disease and 32 with multiple system atrophy) underwent a complete urodynamic evaluation and neurophysiological testing. RESULTS: Of the parkinsonian patients 36.6% had normal micturition findings with normal bladder sensitivity; 26.7% had delayed or incomplete pelvic floor relaxation; 26.7% had hyperreflexia with vesicosphincteric synergy; and 10% had hyperreflexia with vesicosphincteric synergy associated with incomplete pelvic floor relaxation. Parkinsonian patients with a normal urodynamic pattern had significantly less severe disease and a shorter duration of disease in years than those who had abnormal patterns. Patients with hyperreflexia had significantly higher severity of disease. All the patients with multiple system atrophy had hyperreflexia with synergy. Two urodynamic patterns were identified: hyperreflexia with vesicosphincteric synergy (90.6% of patients), and hyperreflexia with vesicosphincteric synergy and incomplete pelvic floor relaxation (in 9.4%). Hyperreflexia with synergy correlated neither with the severity nor with the duration of disease. Sphincter EMG analysis showed that all the parkinsonian patients had normal sphincter EMG whereas 24 of the 32 patients with multiple system atrophy had neurogenic signs. CONCLUSIONS: Urodynamic evaluation and sphincter EMG are both useful tests in the differential diagnosis between Parkinson's disease and multiple system atrophy. Urodynamic findings may be abnormal before patients with multiple system atrophy reach an advanced stage of the disease. Recordings of EMGs from perineal muscles become abnormal as the disease progresses in multiple system atrophy but not in Parkinson's disease.

Aged↗
PubMed2003

Urodynamic study and potassium sensitivity test for women with frequency-urgency syndrome and interstitial cystitis.

PURPOSE: The intravesical potassium chloride (KCl) sensitivity test has been used to detect urothelial leakage in patients with frequency-urgency syndrome and interstitial cystitis (IC). It is unclear whether urodynamic studies can predict a positive KCl test. This study compared the urodynamic results for women with different KCl responses who suffered from frequency-urgency syndrome and IC. METHODS: A total of 196 women suffering from frequency, urgency and/or bladder pain were enrolled in this study. These patients underwent a urodynamic study with a concurrent KCl test. The urodynamic results were compared between the patients who had positive and those who had negative KCl tests and between the patients with and without characteristic IC under cystoscopic hydrodilatation. RESULTS: Among 196 women, 138 (70.4%) had a positive and 58 (29.6%) a negative KCl test. Among the patients with a positive KCl test, 128 underwent cystoscopic hydrodilatation: 44 were proven to have characteristic IC, and 84 were not. Patients with a negative KCl test had a larger residual urine volume and a higher incidence of poor relaxation of the urethral sphincter than those with a positive test. However, patients with a positive KCl test and proven IC did not differ in urodynamic parameters from non-IC patients. The symptom of bladder pain could not predict a positive KCl test nor characteristic IC either. CONCLUSIONS: This study shows that no specific urodynamic parameter or specific symptoms can predict a positive KCl test in patients with frequency-urgency syndrome or IC. Patients with bladder pain at full bladder and a positive KCl test had only a 45.2% chance to have characteristic IC.

Administration, Intravesical↗
PubMed2003

Effects of different sex hormones on male rabbit urodynamics: an experimental study.

BACKGROUND: The effects of different sex hormones on urodynamics in female rabbits have been investigated previously. Estrogen induces an increase in bladder capacity and compliance, whereas testosterone and progesterone reduced bladder capacity and compliance. OBJECTIVE: The aim of this study was to investigate the effects of sex hormones on bladder urodynamics in male rabbits. METHODS: 5 groups were set up for the study: group I, low midline laparotomy (LML) + 0.9% NaCl; group II, LML + testosterone; group III, LML + bilateral orchiectomy (BO) + testosterone; group IV, LML + BO + progesterone, and group V, LML + BO + estrogen. Baseline urodynamic records and blood sex hormone levels were measured. In the follow-up all rabbits from each group underwent urodynamics 5, 10 and 30 days after injection. Estrogen, progesterone and testosterone levels were also measured during the follow-up period. For statistical verification Mann-Whitney U and Kruskal-Wallis chi(2) tests were used. RESULTS: Hormone levels: Testosterone levels were found to be increased in groups II and III 5 and 10 days after the injection. Testosterone declined thereafter and returned to baseline levels on day 30. In groups IV and V progesterone and estrogen levels increased after the injection and returned to baseline levels on day 30. Urodynamics: In groups II and III testosterone increased the bladder capacity and compliance on days 5 and 10. In these groups, capacity and compliance decreased thereafter and returned to the baseline levels on day 30. These urodynamic findings correlated with the alterations in blood testosterone levels. In groups I and IV no changes were observed in bladder capacity and compliance. In group V capacity and compliance were found to be increased on day 5 after the injection and returned to baseline levels on day 30. The changes in bladder capacity were found to be statistically significant in groups II, III and V. CONCLUSION: In this study, after the injection of testosterone, bladder capacity and compliance increased with high blood testosterone levels in male rabbits. The most interesting finding was observed in the estrogen group, questioning the role of estrogens in males. These findings allow us to reconsider the role of sex hormones in bladder functions.

Abdomen↗
PubMed2005

Consistency of urodynamic parameters in children with detrusor instability: how many times should the bladder be filled?

INTRODUCTION: It is recommended that the bladder be filled at least twice to perform a standard urodynamic study. However, the procedure is time-consuming and distressing for both the patient and the professional. The impact of the number of fillings on urodynamic parameters in children with normal urodynamic results and those with detrusor instability is presented in this study. PATIENTS AND METHODS: Urodynamic data from 70 children with detrusor instability and 42 with normal urodynamic parameters who had undergone 3 consecutive fillings in a single session during a 2-year period were reviewed retrospectively. The variable parameters that were compared between the 2 groups were the mean bladder capacity ratio, maximum filling pressure and the number of contractions during the filling phase. RESULTS: In the normal group, no difference was found in bladder capacities between the 3 fillings, but there was a significant decrease in the maximum bladder filling pressures in the subsequent fillings. In children with detrusor instability, the number of contractions in the 1st filling was significantly higher than those in the subsequent fillings. Also in this group, a significant difference in the mean bladder capacities between fillings was noted as well as a decrease in the maximum bladder filling pressures in contrast to normal bladders. CONCLUSION: In patients with suspected detrusor instability the bladder should be filled at least twice for a reliable urodynamic assessment. Two normal fillings without contractions, with normal capacity and normal maximum bladder filling pressure are highly suggestive of a normal 3rd filling.

Case-Control Studies↗
PubMedDate not supplied

[Genitourinary changes in multiple sclerosis: the need for a urodynamic study].

OBJECTIVE: In this study we have evaluated the urinary and sexual alterations of patients with multiple sclerosis (MS) by means of neurourological and neuroandrological studies. PATIENTS AND METHODS: In 41 patients with MS we took a clinical history and made a neurourological physical examination. We also did a full urodynamic study including measurement of flow and postmictional residue, cystomanometry and test of the detrusor pressure/mictional flow. Selective electromyography of the periurethral sphincter and a cystourethrographic study were also done. In patients complaining of erection dysfunction this was also studied by means of an erection test with intracavernosal vasoactive drugs and special neurophysiological techniques including the obtention of S2-S4 evoked potentials in the bulbo-cavernosal muscle and the somatosensorial potentials of the pudendal nerve. RESULTS: In patients with MS there is a predominance of mixed and irritative urinary symptoms rather than obstructive symptoms. The vesico-urethral dysfunction of upper motor neurone type was the most frequent urodynamic diagnosis. There were no statistically significant differences between the urinary symptoms of the different urodynamic diagnoses. Ninety percent of the patients with erectile dysfunction had associated vesico-urethral dysfunction of upper motor neurone type and 100% of the patient with erectile dysfunction had dysfunction of the sphincter of the urinary bladder. CONCLUSIONS: In patients with MS there is no correlation between the clinical symptoms and urodynamic diagnosis. Therefore urodynamic diagnosis is essential not only for diagnosis but also for development of suitable treatment. The urodynamic diagnosis of dysfunction of the bladder sphincter is a risk factor in patients with MS. In our series 100% of the cases with erectile dysfunction also had dysfunction of the bladder sphincter.

Adult↗
PubMed2000

The urodynamic profile of myelodysplasia in childhood with spinal closure during gestation.

PURPOSE: Spinal dysraphism is the most common cause of neurogenic bladder dysfunction in newborns. Urodynamic findings in these patients include uninhibited bladder contractions, bladder areflexia, decreased compliance and detrusor-sphincter dyssynergia. Early urodynamic studies are recommended for spina bifida to help identify bladder characteristics that may cause a risk of upper tract deterioration. We recently evaluated a new early type of intervention involving closure of the neural tube defect during gestation in 25 patients at our institution. We hypothesize that this procedure results in decreased exposure of the spinal cord to amniotic fluid, which may improve neurological function. To date we have evaluated 16 of the 25 patients with video urodynamics. We compared the results to those in the literature on patients with myelomeningocele and without prenatal intervention. MATERIALS AND METHODS: We performed urodynamic testing in 16 patients with a mean age of 6.5 months, including cystometrography, fluoroscopic evaluation of filling and voiding, pelvic floor electromyography and post-void residual urine measurement. In addition, we retrospectively reviewed renal ultrasound, voiding cystourethrography, catheterization need, number of urinary tract infections and medication in these cases. RESULTS: Uninhibited detrusor contractions and an areflexic bladder were identified in 6% and 43% of patients, respectively, while 19% had decreased compliance and 75% had leak point pressure greater than 40 cm. water. Mean bladder capacity was 40 cc and 31% of patients had much lower capacity than expected for age. Previous renal ultrasound and voiding cystourethrography showed evidence of upper tract dilatation and reflux in 2 cases, respectively. Intermittent catheterization and anticholinergic therapy were required by 1 patient each and 1 had a significant urinary tract infection. CONCLUSIONS: Urodynamic findings in this population are comparable to those previously reported in the literature in patients with spina bifida without prenatal closure of the spinal defect. The lower incidence of urinary tract infection and reflux in our study probably represents more aggressive early urological management rather than neurological improvement. These urodynamic studies were performed early in life and future evaluation may ultimately reveal improved bladder function compared with that in others with myelodysplasia. However, at this time we recommend that patients who undergo spinal cord defect closure during gestation be evaluated and treated in the same manner as those with myelomeningocele but without fetal intervention.

Child↗
PubMed2000

Voiding dysfunction and Parkinson's disease: urodynamic abnormalities and urinary symptoms.

PURPOSE: We evaluated bladder dysfunction and Parkinson's disease in regard to disease severity and determined whether subjective patient urinary symptoms correlated with urodynamic abnormalities. MATERIALS AND METHODS: We assessed bladder dysfunction in 70 patients with Parkinson's disease and urinary symptoms using the International Prostate Symptom Score and urodynamic tests. RESULTS: Urodynamic evaluation revealed detrusor hyperreflexia in 47 patients (67%), hyporeflexia or areflexia in 11 (16%), hyperreflexia with impaired contractile function in 6 (9%), hyperreflexia with detrusor-sphincter dyssynergia in 2 (3%) and normal function in 4 (6%). The incidence of urodynamic abnormalities appeared to increase with disease severity. However, the only urodynamic parameter that correlated with disease severity was post-void residual urine volume. On the other hand, symptom index scores increased with disease severity. The irritative symptom score correlated with maximum cystometric capacity and volume at initial desire to void, whereas the obstructive symptom score correlated with post-void residual urine volume. Also, irritative and obstructive scores were good predictors of overactivity during the storage and underactivity at the voiding phases. CONCLUSIONS: Bladder function may deteriorate progressively with advancing disease. Symptom scores are fairly accurate for predicting likely urodynamic abnormalities. Our results imply that quantifying subjective urinary symptoms is useful for estimating the severity and type of bladder dysfunction.

Adult↗
PubMed2001

The intravesical potassium sensitivity test and urodynamics: implications in a large cohort of patients with lower urinary tract symptoms.

PURPOSE: Bladder outlet obstruction secondary to benign prostatic hyperplasia (BPH) is the most common diagnosis in older men with lower urinary tract symptoms. However, these symptoms also can occur with interstitial cystitis. We determine whether the potassium sensitivity test is useful for distinguishing BPH from possible intersitial cystitis in patients with lower urinary tract symptoms. We also test the hypothesis that patients with these symptoms who have a positive test will have urodynamic findings consistent with the diagnosis of interstitial cystitis. MATERIALS AND METHODS: The potassium sensitivity test was performed in 526 (95%) males and 25 (5%) females with lower urinary tract symptoms undergoing urodynamic testing. Urodynamic parameters in the positive and negative potassium sensitivity test groups were compared. % RESULTS: Of the patients 16% (89 of 551) had a positive potassium sensitivity test. Compared with patients who had a negative test, those who had a positive test were younger (61 versus 64 years, p = 0.03), had urgency at significantly lower volumes (108 versus 182 cc, p <0.0001), lower bladder capacity (343 versus 436 cc, p <0.0001) and lower post-void residual (49 versus 95 cc, respectively, p <0.001). Urodynamic parameters in the 24% (6 of 25) of women who had a positive potassium sensitivity test were similar to those in men who also had a positive test. CONCLUSIONS: Urodynamic findings in patients with lower urinary tract symptoms who have a positive potassium sensitivity test are significantly different from those in patients who have a negative test, and are similar to those findings characteristic of interstitial cystitis. Interstitial cystitis should be considered in patients with lower urinary tract symptoms who have a positive test. The potassium sensitivity and urodynamic tests may be a useful combination for screening men with lower urinary tract symptoms to identify those symptoms that may be due to interstitial cystitis versus BPH.

Administration, Intravesical↗
PubMed2002

Removal of transurethral catheter during urodynamics may unmask stress urinary incontinence.

PURPOSE: The measurement of Valsalva leak point pressure may have an important role in the treatment algorithm of women with stress urinary incontinence. However, some patients with stress urinary incontinence may not have leakage during standard urodynamic studies and, thus, the Valsalva leak point pressure cannot be determined. We hypothesized that the transurethral catheter may inhibit leakage during urodynamics. MATERIALS AND METHODS: We evaluated 21 consecutive women presenting with complaints of stress urinary incontinence who failed to have leakage on urodynamic studies. Bedside cystometry was performed, followed by urodynamics using a 6Fr transurethral catheter. When stress urinary incontinence was not noted, the catheter was removed and the Valsalva leak point pressure was measured using the intraabdominal pressure catheter. RESULTS: No woman had leakage on urodynamic studies with the catheter in place, although 11 of 21 had leakage after the catheter was removed and 15 had leakage on bedside cystometry. All 11 patients with leakage at catheter removal showed leakage on bedside stress testing. Mean Valsalva leak point pressure in those with leakage was 67 cm. water. CONCLUSIONS: Patients with a history of stress urinary incontinence and those with a positive bedside stress test who do not have leakage during a Valsalva maneuver on urodynamic studies should repeat the Valsalva maneuver with the catheter out. This technique may unmask stress urinary incontinence and allow the measurement of Valsalva leak point pressure.

Female↗
PubMed2002

Relationship of urodynamic parameters and obesity in women with stress urinary incontinence.

OBJECTIVE: To identify the relationship of obesity and stress urinary incontinence and of obesity and urodynamic parameters in patients with stress urinary incontinence (SUI). STUDY DESIGN: The study included 98 women who were clinically diagnosed as having stress urinary incontinence and 102 women, the control group, who had no stress urinary incontinence. We compared body mass index (BMI) as a parameter of obesity between the two groups. BMI was defined as weight (in kilograms) divided by height (in square meters). All patients with SUI underwent urodynamic tests, and we determined the relationship between BMI and urodynamic parameters by using the Pearson correlation coefficient. RESULTS: There was no difference in age between the two groups. However, BMI was significantly higher in women with SUI than in the control group. There were more vaginal deliveries and higher parity in women with SUI than in the control group. BMI was significantly higher in women with SUI than in the control group only in the younger group, while parity and number of vaginal deliveries were higher in the SUI group than control group among all age groups. The coefficient of multiple logistic regression between obesity and SUI was .131 (r = .131). There was no relationship between BMI and urodynamic parameters among patients with SUI. The average intraabdominal pressure was significantly increased in the obese group over that in the nonobese group. Correlation between BMI and intraabdominal pressure showed a close relationship. CONCLUSION: BMI was higher in the SUI group than control group. Obesity may be an important etiologic factor in SUI but did not influence urodynamic parameters, and there was no relationship between BMI and urodynamic parameters.

Adult↗
PubMed1992

[Multifactorial urodynamic study of 115 patients with dysuria and benign prostatic hypertrophy].

Discriminant analyses based on preoperative urodynamic parameters have proved inaccurate in predicting functional results after prostatectomy. To investigate the cause of this failure, we studied a group of 115 patients consecutively referred for prostatism and selected for prostatic surgery only on clinical criteria and flow rate. A preoperative urodynamic work-up was performed, including cystometry and urethrometry. The patients were reexamined 2 months postoperatively and underwent control uroflowmetry. All preoperative urodynamic data were computed simultaneously using principal component analysis and canonical discriminant analysis. The significance of the diagrams obtained with these multifactorial analyses was more closely examined than in previous studies. The results of classification by the discriminant function demonstrating the best combination of preoperative urodynamic variables resulted in 44% of patients being correctly rated. Examination of the diagrams showed that the major cause of failure in previous studies was the great variety of urodynamic conditions in men with prostatism, which indicates a need for multifactorial interpretation of the results of urodynamic explorations.

Aged↗
PubMed2005

Correlation between symptoms and urodynamic findings in Thai female patients with urinary incontinence.

OBJECTIVE: To determine the accuracy of a urinary incontinence questionnaire in the diagnosis of various types of urinary incontinence classified according to the results of multichannel urodynamic testing. MATERIAL AND METHOD: Between May 2000 and April 2004, 129 women with symptoms of urinary incontinence were interviewed using a urinary incontinence questionnaire consisting of 12 urinary symptoms questions. Various patient demographic and other descriptive data were also collected. All patients underwent multichannel urodynamic testing, and classified using the International Continence Society criteria. Descriptive data and patient symptoms were tested for statistical association with the types of urinary incontinence. Sensitivity and specificity were used to measure the accuracy of the symptoms in distinguishing between the various urodynamic conditions. RESULTS: Of the 12 questions, only three questions (two stress incontinence symptoms and one overactive bladder symptom) were significantly associated with the urodynamic diagnoses of genuine Stress Urinary Incontinence (SUI) and Detrusor Overactivity (DO). The sensitivity and specificity for distinguishing between genuine SUI and DO from other urodynamic diagnoses or between each other were relatively low. CONCLUSION: Symptoms of urinary incontinence were not sufficient to predict types of urinary incontinence. Therefore, the authors suggest that urodynamic testing is still essential in the diagnosis and management of female urinary incontinence.

Diagnostic Techniques, Urological↗