scholarly journals Treatment Strategy According to Findings on Pressure-Flow Study for Women with Decreased Urinary Flow Rate

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Yoshinori Tanaka ◽  
Naoya Masumori ◽  
Taiji Tsukamoto ◽  
Seiji Furuya ◽  
Ryoji Furuya ◽  
...  
Keyword(s):  
Flow Rate ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Pressure Flow ◽  
Female Patients ◽  
Detrusor Contractility ◽  
Urethral Dilatation ◽  
Pressure Flow Study ◽  
Distigmine Bromide ◽  
Flow Study

Purpose. In women who reported a weak urinary stream, the efficacy of treatment chosen according to the urodynamic findings on pressure-flow study was prospectively evaluated.Materials and Methods. Twelve female patients with maximum flow rates of 10 mL/sec or lower were analyzed in the present study. At baseline, all underwent pressure-flow study to determine the degree of bladder outlet obstruction (BOO) and status of detrusor contractility on Schäfer's diagram. Distigmine bromide, 10 mg/d, was given to the patients with detrusor underactivity (DUA) defined as weak/very weak contractility, whereas urethral dilatation was performed using a metal sound for those with BOO (linear passive urethral resistance relation 2–6). Treatment efficacy was evaluated using the International Prostate Symptom Score (IPSS), uroflowmetry, and measurement of postvoid residual urine volume. Some patients underwent pressure-flow study after treatment.Results. Urethral dilatation was performed for six patients with BOO, while distigmine bromide was given to the remaining six showing DUA without BOO. IPSS, QOL index, and the urinary flow rate were significantly improved in both groups after treatment. All four of the patients with BOO and one of the three with DUA but no BOO who underwent pressure-flow study after treatment showed decreased degrees of BOO and increased detrusor contractility, respectively.Conclusions. Both BOO and DUA cause a decreased urinary flow rate in women. In the short-term, urethral dilatation and distigmine bromide are efficacious for female patients with BOO and those with DUA, respectively.

scholarly journals The Role of Urodynamic Investigations in Management of Stress Urinary Incontinence

2015 ◽  
Vol 61 (4) ◽  
pp. 298-302
Author(s):  
Veronica Maria Ghirca ◽  
D Porav-Hodade ◽  
C Chibelean ◽  
S Voidazan ◽  
M Vartolomei ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Surgical Treatment ◽  
Stress Urinary Incontinence ◽  
Abdominal Pressure ◽  
Detrusor Contraction ◽  
Pressure Flow ◽  
Detrusor Contractility ◽  
Urodynamic Investigations ◽  
Pressure Flow Study ◽  
Flow Study

AbstractObjective: The aim of this study is to establish the importance of urodynamic investigations in women diagnosed with stress urinary incontinence (SUI) who have indication of surgical treatment.Methods: We performed a retrospective study over a period of 3 years (January 2012-December 2014) in Clinic of Urology from Tirgu Mures. The inclusion criteria were: female patients diagnosed with SUI having indication of surgical treatment and the existence of urodynamic investigations (uroflowmetry and pressure-flow study). We evaluated 118 patients with SUI. From this patients, 24 cases (20.3%) accomplished the criteria from above.Results: We included in this study 24 patients aged 64.25+/−8.25 (standard deviation). Pressure-flow study revealed an impaired detrusor contraction in 13 cases. Statistical anaysis pouved a relation between existence of post void residual urine (PVR) and underactive detrusor (UD) (p=0.01). There is no correlation between maximum flow rate (Qmax) and UD, r=0.18 (CI= −0.2-0.5), p=0.3 and between normal value of Qmax and normal detrusor pressure (Pdet), r= 0,28(CI=−0.6-0.8), p=0.58. Also there is no relation between a low Qmax and UD, p=0,5. There is a statistical relation between increased abdominal pressure (Pabd) and UD, p=0.02.Conclusions: Uroflowmetry has the role to guide us concerning the micturition process Pressure-flow study is indicated in management of SUI, in selected cases, in patients with voiding symptomatology, the suspicion of a detrusor contractility dysfunction, abnormal uroflowmetry results, existence of PVR, in prediction of the surgical treatment outcome or if we think that the findings can change the choice of treatment.

scholarly journals Urodynamic Pressure-Flow Study (Pfs) for the Prediction of Surgical Outcome in Bph With Urinary Retention

2020 ◽  
Vol 19 (2) ◽  
pp. 74-77
Author(s):  
Md Monowarul Islam ◽  
ATM Aman Ullah ◽  
Mohammad Abdus Salam ◽  
Tohid Mohammad Saiful Hossain ◽  
AKM Khurshidul Alam ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Pressure Flow ◽  
Detrusor Contractility ◽  
Number Of Patients ◽  
Pressure Flow Study ◽  
Group A ◽  
Group B ◽  
Flow Study

Introduction: Urinary retention can be either chronic or acute in onset. Urinary retention can result from impaired detrusor contractility or obstruction of bladder outlet. Twenty five to 30% of men with decreased flow are not obstructed 1. Either uroflowmetry or post-void residue (PVR) can not differentiate obstruction from impaired detrusor contractility. In this study, an effort has been paid to know the usefulness of pressure-flow study in urinary retention due to suspected benign prostatic hyperplasia(BPH) cases for predicting the outcome of surgery. Methods: This is a before after clinical study, conducted in Bangabandhu Sheikh Mujib Medical University, Dhaka. Total 32 patients were selected for the study. Patients age ranges from 49-78 years.Patients with chronic and refractory urinary retention due to BPH were enrolled for the study. They were divided into group A (pre-operative) and group B (Post-operative). TURP was done in all 32 patients by single surgeon. Study variables were detrusor pressure at maximum flow (Pdet@Qmax), bladder outlet obstruction index(BOOI), bladder contractility index( BCI) and post void residue (PVR). Result: Total number of patients was 32. Age ranges from 49-78 years. Twenty one (65.6%) had BPH with chronic retention and 11 (34.4%) had BPH with refractory retention.Pdet@Qmax between Group A and Group B was highly significant (p=0.001). But difference is not significant in Pdet@Qmax d” 40 subgroup of patients (p=0.673). Bladder outlet obstruction index between Group A and Group B is highly significantly (p=0.001), but, that does not observed in BOOI <20 subgroup(p=0.600). Bladder contractility index in both Normal (BCI 100-150) and strong ( BCI >150 ) subgroups are significant ( p=0.001 and 0.001 respectively ). But it is not significant in BCI<100 sub group (p=0.021). Post void residue between Group A and Group B is highly significant (p=0.001). But in PVR >300m subgroup, difference is insignificant (p=0.120). Conclusion: In this study, overall favorable outcome observed in all patients after TURP but Pdet@Qmax <40 cm of water, BOOI <20, BCI <100 and PVR >300 ml groups of patients are at high risk of unfavorable clinical outcome after TURP. With the help of presence flow study (PFS) prior knowledge of these factors, it is possible to predict postoperative outcome. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.74-77

scholarly journals Association of Detrusor Muscular Activity With the Outcome of Transurethral Resection of Prostate in Patients With Severity of Bladder Outflow Obstruction

2020 ◽  
Vol 18 (2) ◽  
pp. 56-61
Author(s):  
Md Naushad Alam ◽  
Md Fazal Naser ◽  
Kamrun Nahar ◽  
Md Waliul Islam ◽  
Md Mamunur Rashid ◽  
...  
Keyword(s):  
Flow Rate ◽  
Urine Volume ◽  
Muscular Activity ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Residual Urine Volume ◽  
Outflow Obstruction ◽  
College Hospital ◽  
Medical College ◽  
Detrusor Contractility

Objective: To evaluate the association of detrusor muscular activity with outcome of TURP in patients with severity of bladder outflow obstruction. Methods: This is a hospital based cross sectional study conducted in the Department of Urology of Dhaka Medical College Hospital, Dhaka.Elderly male patients having lower urinary tract symptoms (IPSS=20-35) with no retention (non-catheterized patient), who attended in Dhaka Medical College Hospital, were included in the study. A total of 73 patients meeting the enrollment criteria were included in the study. They were evaluated by history, physical examination including DRE and necessary investigations to identify the potential candidates for TURP. Then the potential participants were counseled for Urodynamic study. All patients underwent TURP by expert surgeon. Three months after TURP, repeat Urodynamic study was done and the results were compared to see the outcome. Afterward the data were plotted for the clarification of detrusor contractility at three levels: normal detrusor contractility (voiding pressure 40-60cm of water), detrusor over activity (voiding pressure >60cm of water) and detrusor under activity (voiding pressure <40 cm of water). According to the provisional ICS nomogram for the analysis of voiding, patients were divided into three classes. In BOO Index(PdetQmax-2Qmax),obstructed(BOOI > 40); equivocal(BOOI=20-40);Unobstructed(BOOId” 20) are taken into consideration. The test statistic used to analyze the data was descriptive statistics and ANOVA test. The level of significance was set at 0.05 and P<O.05 was considered significant. Results: Out of 73 patients 8 didn’t attend follow up session and hence excluded keeping 65 for final analysis. The mean age was 66.3 ± 9.7 years (50- 87 years) .Detrusor over activity was present in 13(20%), normal detrusor contractility was observed in 46(70.8%) and weak contractility in 6(9.2%). Peak urinary flow rate was almost similar among patients of different groups. However, voided volume and residual volume were lowest in overactive group and highest in underactive group, while normal group was in between two (p = 0.007 and p = 0.046 respectively). Maximum urinary flow rate and voided urine between patients of moderate and severe bladder outlet obstruction were almost comparable (p =0.120 and p = 0.270 respectively). However, residual urine volume was much higher in the patients of moderate BOO than that in severe BOO (p = 0.001).The patients of OAB experienced a significant improvement in percentage of reduction of residual urine volume compared to normal and underactive bladder (p = 0.002), However, there were no significant difference among the patients with overactive, normal and underactive bladder with respect to peak urinary flow rate and voided urine volume (p = 0.499 and p = 0.847 respectively). Conclusion: TURP is an effective surgical procedure for treatment of BPH, especially for patients with severe degree of BOO with normal or overactive detrusor contraction. Bangladesh Journal of Urology, Vol. 18, No. 2, July 2015 p.56-61

Diagnostic Parameters

1992 ◽  
Vol 59 (1) ◽  
pp. 21-25 ◽  
Author(s):  
W. Artibani
Keyword(s):  
Critical Role ◽  
Benign Prostatic Hypertrophy ◽  
Point Of View ◽  
Pressure Flow ◽  
Homogeneous Groups ◽  
Detrusor Contractility ◽  
Pressure Flow Study ◽  
Voided Volume ◽  
Flow Study

Many parameters are available for evaluating patients with benign prostatic hypertrophy (BPH) in order to assess the necessity for treatment and to evaluate results. At present there is no real agreement on their order of importance. This paper tries to define from a theoretical and practical point of view the role of the following parameters: symptoms; symptom scores; visual scores; time/voided volume chart; prostate size; uroflowmetry, nomograms for flow; residual urine; pressure/flow study; mathematical and computer processing of pressure/flow study. The Author underlines the critical role of invasive urodynamics (pressure/flow study) in categorizing patients as obstructed or non-obstructed, in grading the severity of outflow obstruction and in evaluating the pattern of detrusor contractility. Present studies to evaluate the results of old and recent treatments should include invasive urodynamics in order to obtain homogeneous groups of patients and to overcome the prevailing empiricism.

Stop test or pressure-flow study? Measuring detrusor contractility in older females

2004 ◽  
Vol 23 (3) ◽  
pp. 184-189 ◽  
Author(s):  
Thai Lian Tan ◽  
Margaret A. Bergmann ◽  
Derek Griffiths ◽  
Neil M. Resnick
Keyword(s):  
Pressure Flow ◽  
Detrusor Contractility ◽  
Stop Test ◽  
Pressure Flow Study ◽  
Flow Study

Impact Of Transurethral Resection Of Prostate On International Prostate Symptom Score And Peak Urinary Flow Rate

2020 ◽  
Vol 16 (1) ◽  
pp. 11-15
Author(s):  
Md Waliul Islam ◽  
Md Abul Hossain ◽  
Md Nurul Hooda ◽  
Kazi Rafiqul Abedin ◽  
Husne Ara
Keyword(s):  
Flow Rate ◽  
Transurethral Resection ◽  
Urine Volume ◽  
T Test ◽  
Urinary Symptoms ◽  
Urinary Flow Rate ◽  
Transurethral Resection Of Prostate ◽  
Urinary Flow ◽  
Paired Student ◽  
The Impact

Objectives: To evaluate urinary symptoms and quality of life in patient with BPH before and after TURP. To determine the impact of TURP on the urinary symptoms (IPSS) and peak urinary flow rate. Methods: This study is prospective study carried out between 2010 and 2011 in the department of Urology, National Institute of Kidney Diseases & Urology. Total 102 cases were selected purposively according to selection criteria. Each patient was observed and followed up at 8 weeks (1st visit), 16 weeks (2nd visit) 24 weeks (3rd visit) after transurethral resection of prostate (TURP). IPSS score, QOL score also recorded and uroflowmetry was done to see the peak urinary flow rate (Qmax) of urine and voiding time. USG was done to see post voidal residual urine volume and DRE also done in selected cases. Data was complied and statistical analysis were done using computer based software, Statistical Package for Social Science (SPSS), using paired ‘t’ test. A P value <0.05 was taken as significance. Results: Before TURP, IPSS range 17-25 and mean 21.61+2.43, after TURP, range 0-7 and mean 4.27+1.71). Hence a significant improvement of IPSS was found from 2 months to 6 months follow up after TURP. The change was tested using “paired student ‘t’ test”. Before TURP Qmax range 7-12.2 and mean was 9.96+1.69, which became range 18-25 and mean was 22.61+2.28 after TURP and therefore change of mean Qmax was 12.64+2.69. The change was tested using “paired student ‘t’ test”. The change was found significant (P<0.001). Conclusion: Transurethral resection of prostate resolves obstructive symptoms, rapid improvement of urinary flow rate Bangladesh Journal of Urology, Vol. 16, No. 1, Jan 2013 p.11-15

scholarly journals Variability of Urinary Creatinine in Healthy Individuals

2021 ◽  
Vol 18 (6) ◽  
pp. 3166
Author(s):  
Gerd Sallsten ◽  
Lars Barregard
Keyword(s):  
Flow Rate ◽  
Excretion Rate ◽  
Time Of Day ◽  
Urinary Flow Rate ◽  
Urinary Flow ◽  
Diurnal Variability ◽  
Creatinine Excretion ◽  
Blood Samples ◽  
Urinary Creatinine ◽  
Creatinine Excretion Rate

Many urinary biomarkers are adjusted for dilution using creatinine or specific gravity. The aim was to evaluate the variability of creatinine excretion, in 24 h and spot samples, and to describe an openly available variability biobank. Urine and blood samples were collected from 60 healthy non-smoking adults, 29 men and 31 women. All urine was collected at six time points during two 24 h periods. Blood samples were also collected twice and stored frozen. Analyses of creatinine in urine was performed in fresh urine using an enzymatic method. For creatinine in urine, the intra-class correlation (ICC) was calculated for 24 h urine and spot samples. Diurnal variability was examined, as well as association with urinary flow rate. The creatinine excretion rate was lowest in overnight samples and relatively constant in the other five samples. The creatinine excretion rate in each individual was positively correlated with urinary flow rate. The creatinine concentration was highest in the overnight sample and at 09:30. For 24 h samples the ICC was 0.64, for overnight samples it was 0.5, and for all spot samples, it was much lower. The ICC for urinary creatinine depends on the time of day of sampling. Frozen samples from this variability biobank are open for researchers examining normal variability of their favorite biomarker(s).

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