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At least 19 recordsLinked to original sources
PubMed2003

[Rationale of Doppler urodynamics and urodynamics. What does Doppler contribute to urodynamics?].

OBJECTIVES: To make an analysis of the usefulness of urodynamic tests and what can be obtained from them. METHODS: We also perform and analytical deduction of those parameters that define detrusor behavior, such as the constant defining bladder compliance, the bladder elastic constant, in its tensile properties, and we found the expression of resistances and calculate the abdominal pressure formula; therefore we don't need to introduce a rectal catheter to know the value of those parameters that define bladder dynamics. RESULTS: Although they are provisional, they allow foreseeing a promising future for this application of a well-known device. CONCLUSIONS: Currently, we can only define the bladder behaviour, its resistances, the detrusor drive and compliance with the only discomfort of a perineal Doppler ultrasound. Time will open new possibilities.

Humans↗
PubMed2003

Quality control in urodynamics: a review of urodynamic traces from one centre.

OBJECTIVE: To investigate quality control in our unit and to enable other units to compare their results, as experience from central reviews of urodynamic traces for multicentre trials has suggested that poor quality control is common. PATIENTS AND METHODS: All consecutive male urodynamic tests conducted over 1 year were reviewed. A list of criteria to assess the quality of the records was devised, based upon International Continence Society guidelines on "good urodynamic practice", and on other sources. Eligible traces were analysed for aspects of quality control, e.g. baseline pressures and coughs to test pressure transmission. The data were analysed to establish how often quality criteria were met, and identify areas for improvement. RESULTS: In 100 eligible traces, the baseline detrusor pressure was 0-10 cmH2O in 86, and - 5 to +10 cmH2O in 94%. Baseline intravesical and abdominal pressure were 30-50 cmH2O in 68% and 73% of cases, respectively. Coughs were present before filling in 94%, during filling in 95%, before voiding in 72% and after voiding in 87% of cases. The cough-test frequency was sufficient in 30% of traces. In 11 the intravesical pressure line fell out during voiding. CONCLUSION: Most of the traces assessed met the quality criteria defined, but significant defects were not uncommon. Some of the problems identified suggest areas of urodynamic technique which should be studied in more detail. We intend to modify our quality control practices, and hope to show an improvement on re-audit. We hope that other urodynamic departments will be encouraged to review their practice, and we aim to improve our results.

Adult↗
PubMed2004

A comparison of urodynamic parameters and lower urinary tract symptoms in urodynamic genuine stress incontinence women with or without stress urinary incontinence.

BACKGROUND: The aim of this study was to investigate the urodynamic parameters and lower urinary tract symptoms (LUTS) of women with urodynamic genuine stress incontinence (GSI). METHODS: A cross-sectional study involving 3323 women with LUTS was conducted. We recruited 1261 women with urodynamic GSI and were further grouped as with or without symptomatic stress urinary incontinence (SUI). The LUTS and urodynamic measurements between the two groups were analyzed and compared. RESULTS: Women with symptomatic SUI had a greater maximal flow rate, larger voided volume, larger maximal cystometric capacity, and smaller maximal urethral closure pressure (MUCP) during both rest and stress. The amount of urine leakage during the 1-hour pad test of GSI women with symptomatic SUI was much greater than women without symptomatic SUI (26.0 g vs 7.2 g, p < 0.001). The significant differences in other lower urinary tract symptoms including nocturia, diurnal frequency, incomplete emptying, poor stream, urgency, urge incontinence, and post-void dribbling in women without symptomatic SUI were all less than women with symptomatic SUI. CONCLUSIONS: The urodynamic parameters and LUTS between the GSI women with or without symptomatic SUI are different. Approximate 15% of the GSI women do not complain of symptomatic SUI. The lower urinary tract symptoms of women with GSI without symptomatic SUI were less prominent than for the GSI women with symptomatic SUI.

Adult↗
PubMed2007

Bladder outlet obstruction index and maximal flow rate during urodynamic study as powerful predictors for the detection of urodynamic obstruction in women.

AIMS: To evaluate whether bladder outlet obstruction index (BOOI), a mathematical index of outlet resistance, in association with maximal flow rate (Qmax) obtained during multichannel urodynamics (UDS) or detrusor pressure at maximal flow rate (PdetQmax) could help the identification of obstruction in women. METHODS: From January 2004 to February 2005, 401 women were assessed in our urodynamic unit. Of these, 133 were neurologically intact women, referred symptoms suggestive of voiding disorders and had an abnormal non-intubated uroflussometry (NIF) (BOO group). A normal NIF was defined as a bell-shaped curve in presence of a Qmax >15 ml/sec and a PVR <50 ml. Symptoms of voiding disorders were ascertained by interview and rated positive if they occurred more than occasionally. Thirty-seven women were enrolled as unobstructed if they presented a normal NIF and symptoms suggestive of voiding disorders less than occasionally (unobstructed group). RESULTS: ROC curve demonstrated similar diagnostic accuracy in the diagnosis of urodynamic obstruction for Qmax obtained during UDS (AUC = 0.908; P < 0.0001; CI99% = 0.831 to 0.985) and BOOI (AUC = 0.879; P < 0.0001; CI99% = 0.794 to 0.918) and the least was seen for PdetQmax (AUC = 0.706; P = 0.001; CI99% = 0.620 to 0.830). A Qmax obtained during UDS cut-off < or =15 ml/sec provides specificity of 85.9% and sensitivity of 78.9%. A BOOI cut-off > or = -8 provides a sensitivity of 80.8% and specificity of 86.1%. The weakest sensitivity (64.2%) and specificity (64.6%) was recorded for PdetQmax > or =28 cmH(2)O. CONCLUSIONS: BOOI and Qmax obtained during UDS appears to be the most discriminating urodynamic parameters of female BOO. The use of these cutoff might facilitate the identification of women with functional and anatomical obstruction.

Aged↗
PubMed2006

Urodynamics after TURP and HoLEP in urodynamically obstructed patients: are there any differences at 1 year of follow-up?

OBJECTIVES: To compare urodynamic findings after holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate (TURP) for the treatment of benign prostatic hyperplasia-related bladder outlet obstruction. METHODS: From January to October 2002, 100 consecutive patients with benign prostatic hyperplasia with obstructive lower urinary tract symptoms were randomized to surgical treatment with either HoLEP (group 1, n = 52) or TURP (group 2, n = 48). All patients were preoperatively assessed using the International Prostate Symptom Score and quality-of-life question, total serum prostate-specific antigen measurement, transrectal ultrasonography, and complete urodynamic study. The operative time, catheterization time, and overall hospital stay were also recorded for both groups. All patients were assessed at 1, 6, and 12 months postoperatively using a complete urodynamic evaluation. RESULTS: All patients were obstructed preoperatively (Schäfer grade greater than 2). Both groups were comparable in terms of age, total serum prostate-specific antigen level, International Prostate Symptom Score, and urodynamic results. At 1, 6, and 12 months of follow-up, no statistically significant differences were recorded in terms of detrussor pressure at maximal urinary flow rate, Schäfer grade (linear passive urethral resistance relation), maximal urinary flow rate, International Prostate Symptom Score, and quality-of-life score. In the HoLEP group, the catheterization time and hospital stay were significantly shorter. Transitory lower urinary tract symptoms after 3 months of follow-up and dysuria were more frequent in the HoLEP group than in the TURP group, although at 12 months of follow-up, the results were comparable. CONCLUSIONS: Both HoLEP and TURP were equally effective in relieving bladder outlet obstruction. Although associated with greater early self-resolving irritative symptoms, HoLEP can guarantee a shorter catheterization time and hospital stay with longer operative times, proposing itself as an attractive alternative to standard TURP.

Aged↗
PubMed1999

Multichannel urodynamics: ambulatory versus standard urodynamics.

Standard urodynamics in the office setting has been the mainstay of urodynamic evaluation. Ambulatory urodynamics has previously been viewed as a research tool only. This article summarizes new studies on ambulatory urodynamics that highlight its potentially more practical and clinical use.

Female↗
PubMed2005

[Prevalence and clinical-urodynamic characteristics of vesical voiding dysfunction in two urodynamic centres].

BACKGROUND: It has been estimated in English medical reports, that the frequency of vesical voiding dysfunction in urogynecological patients is around of 22-24%; however in our country it does not have any published epidemiological study about this problem. OBJECTIVE: To detect the prevalence of vesical voiding dysfunction in our urodynamic unities and describe the clinical and urodynamic findings. MATERIAL AND METHODS: This is a descriptive and retrospective study in which were revised the clinical reports of 300 female patients, that were sent to some of our urodynamic units because they were suffering of lower urinary tract symptoms. Assessment variables included: Patient clinical history, physical examination, urinalysis, urine culture, urethral calibration, Q tip test, urethrocistoscopy, uroflowmetry, multichannel cystometry, electromyography and pressure voiding study. The diagnosis criterion was based in the concept that Blaivas established for vesical voiding dysfunction in women. RESULTS: The diagnosis of vesical voiding dysfunction was established in 72 cases of the total 300 patients analyzed. The most frequent symptom was the irritative vesical type (frequency/urgency), following of weak stream. Some grade of pelvic organ prolapse was detected in 84.8% of cases. Uroflowmetry was normal in 50% of the cases; nevertheless in the morphologic aspect were observed profile signs suggestive of distal vesical obstruction in 75%, and detrusor hypoactivity in 25% of the total of the cases. CONCLUSIONS: The frequency of obstruction in our casuistic was similar to the other authors. The obtained results permit us to confirm that the vesical voiding dysfunction in the urogynecological Mexican patients is a frequent problem in the urogynecological patient; however the diagnostic is complex and require a carefully correlation as clinical as urodynamical aspects in addition to endoscopic and image studies.

Adolescent↗
PubMed2006

Effect of intravesical Resiniferatoxin (RTX) on lower urinary tract symptoms, urodynamic parameters, and quality of life of patients with urodynamic increased bladder sensation.

OBJECTIVES: Intravesical resiniferatoxin (RTX) has been used with variable efficacy in the treatment of detrusor overactivity (DO). Patients with interstitial cystitis (IC) failed to benefit from this treatment, but a single placebo-controlled study in patients with non-IC painful bladders showed that RTX was effective in the short-term. We investigated the efficacy of intravesical RTX in patients with urgency and frequency due to increased bladder sensation. METHODS: Patients with intractable urgency and frequency, with or without urgency incontinence or bladder pain/discomfort, and with no urodynamic evidence of DO were recruited. After a single intravesical instillation of 100ml 50 nM RTX solution, patients were followed at 1, 3, and 6 mo for changes in urodynamics, bladder diary, the King's Health Questionnaire (KHQ), and degree of bladder pain. RESULTS: Fifteen patients (mean age, 52.5 yr) were treated. RTX significantly improved maximum cystometric capacity, volume at first desire to void, mean micturition volume, 24-h frequency, and daytime frequency for up to 6 mo after treatment. The overall KHQ score improved at all time points, with sustained improvements in the Symptom Severity, Incontinence Impact, and Personal Relationships domains. A >50% decrease in pain was reported by five of seven patients with painful bladders at 1 mo, but only one of seven at 6 mo. CONCLUSIONS: In our small open-label study, a single administration of intravesical RTX in patients with frequency and urgency due to increased bladder sensation significantly improved lower urinary tract symptoms, urodynamic parameters, and quality of life for up to 6 mo.

Administration, Intravesical↗
PubMed2003

One-year urodynamic outcome and quality of life in patients with concomitant tension-free vaginal tape during pelvic floor reconstruction surgery for genitourinary prolapse and urodynamic stress incontinence.

The aim of the study was to examine the 1-year urodynamic outcome and quality of life in patients who have had concomitant tension-free vaginal tape insertion during pelvic floor reconstruction surgery. The medical notes of a retrospective cohort of 45 patients who had undergone tension-free vaginal tape together with pelvic floor reconstruction surgery were reviewed. The operative information, the results of the urodynamic studies and the change in the quality-of-life scores 1 year after surgery were examined. The quality of life was assessed with both general and disease-specific quality-of-life questionnaires (General Health Questionnaire (GHQ-12), Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7)). Patient satisfaction was assessed with the validated Chinese version of the Client Satisfaction Questionnaire (CSQ). Forty-five patients underwent tension-free vaginal tape insertion together with pelvic floor reconstruction surgery. The overall objective cure rate was 43%. There was a significant improvement in the disease specific quality-of-life assessment (UDI-6 score 38.3-15.5; P<0.01) and (IIQ-7 score 15.0-4.0; P<0.01). The patients who had a concomitant cystocele repair had a worse objective cure rate than patients without concomitant cystocele repair (38% vs 67%; P=0.19).

Aged↗
PubMed1983

[New aspects of the Heidenreich and Beck perfusion method in urodynamics. I: Practical experience with a complex urodynamic work station].

122 patients with urinary incontinence of all degrees and 32 controls are investigated by means of a complex urodynamic unit constructed by the authors. Essential part is a robust selfmade three-canal-catheter of heatsealed angiographic material with an external diameter of 10 Charr., which undamagedly can be used at least forty times. The unit enables to do cystometries and simultaneous cystourethrotonometries with electromyography of pelvic floor and mictiometries. The investigations are possible at a normal expense in lying or sitting and all intermediate positions. Many urometric parameters had been determined with aid of perfusion uromanometry according to the principle of Heidenreich and Beck. New combinations had been elaborated. The functional length of urethra in stress profile, the maximal urethral closing pressure, the electronically registered urethral closure pressure, the depression factor and the stress quotient are of special importance. By means of these criteria the qualification of the apparently old fashioned perfsuion uromanometry for a modern urodynamic diagnosis could be demonstrated. The results are compared with those obtained with microtransducer technique.

Female↗
PubMed2003

Perugia urodynamic method of analysis (PUMA): a new advanced method of urodynamic analysis applied clinically and compared with other advanced methods.

AIMS: The aim of this study is to compare PUMA curves with different pathologic conditions causing bladder dysfunction in 158 men and 83 women. METHODS: PUMA results in terms of bladder outlet obstruction and detrusor contractility were compared in 92 men with benign prostatic hypertrophy (BPH) and p(ves) congruent with p(det) (i.e., p(abd) congruent with 0) with the results of the urodynamics operator's opinion, the provisional International Continence Society method, Abrams and Griffith's diagram, urethral resistence factor (URA), Schäfer's diagram, and Watt factor. PUMA curves correlated reliably with different pathologic conditions such as obstructive BPH, orthotopic bladder, cystocele, the neurological bladder, and bladder diverticulum. Statistical analysis indicated excellent agreement between PUMA and URA; agreement with other methods was good in cases of obstruction and nonobstruction. In doubtful cases, as diagnosed by standard methods, PUMA agreed only with the Abrams and Griffith's diagram. PUMA and Wmax were in good agreement on detrusor con traction force. Agreement between PUMA and Schäfer's diagram was excellent for patients with detrusor hypercontractility and good for patients with detrusor hypocontractility and normocontractility. PUMA is the only method applicable to women. It is easy to perform. When integrated with other diagnostic tests, it provides realistic data for diagnosis, medical or surgical therapy, and outcome.

Adult↗
PubMed1978

[The diagnosis of urinary incontinence in gynaecology. Indications for urodynamic diagnosis and description of urodynamic diagnostic apparatus (author's transl)].

Our experience with comparative measurements using various methods of diagnosis of urinary incontinence resulted in the development of a urodynamic measurement station within the department. This station is equiped for urethrocystotonometry with microtransducers for urethrocystograms and for lateral urethrocystograms. The technological details of the apparatus are described. The greatest diagnostic value give measurements in the standing patient. The methods of measurement, the interpretation of the results and the pre-operative records of urethral pressure profiles are described. The urethrocystotonometry is especially valuable for functional diagnosis. For the morphologic evaluation and especially in view of the choice of the operative procedure a modified method of the lateral urethrocystogram is used.

Female↗