scholarly journals The effect of a 6 Fr catheter in women: Are they obstructive?

2013 ◽  
Vol 7 (5-6) ◽  
pp. 185 ◽  
Author(s):  
Patrick Richard ◽  
Nydia Icaza Ordonez ◽  
Le Mai Tu
Keyword(s):  
Clinical Symptoms ◽  
Outlet Obstruction ◽  
Urodynamic Study ◽  
Double Lumen ◽  
Exclusion Criteria ◽  
Non Invasive ◽  
Transurethral Catheter ◽  
Pressure Flow Study ◽  
The Mean ◽  
Flow Study

Objectives: Our objective was to evaluate the effect of a 6 Fr transurethral catheter on the uroflowmetry and to assess whether it potentially contributes to the bladder outlet obstruction (BOO) in women.Methods: We reviewed the charts of 1367 women who underwent an urodynamic study. We included patients with a non-invasive free-flow study (NIFFS) and pressure flow study (PFS) performed through a 6 Fr double lumen transurethral catheter.Results: In total, 120 women met the inclusion/exclusion criteria. Mean maximal flow rate (Qmax) was significantly higher (p < 0.001) in the NIFFS (27.2±11.1 mL/s) than in the PFS (19.3±10.6 mL/s). The mean difference between both Qmax was 7.9±12.0 mL/s. Of these women, 92.3% (24/26) with a Qmax <12 mL/s during PFS were found to have a Qmax ≥12 mL/s during the NIFFS. Ten of the 72 women with an available Pdet.Qmax were deemed to have a BOO according to the PFS and all of them had a Qmax >12 mL/s during the NIFFS. Of the 10 patients, only 2 reported obstructive symptoms.Conclusion: The presence of 6 Fr transurethral catheters alters the PFS and results in a significant reduction of the Qmax in patients who voided more than 250 mL. We believe that NIFFS should be performed in all patients before any urethral manipulation to lower a possible overdiagnosis of BOO and findings should always be correlated to clinical symptoms.

scholarly journals CORRELATION BETWEEN PCAR WITH IPSS SCORE, QMAX, AND POST VOIDING RESIDUAL URINE AND ITS CUT-OFF VALUE IN DETERMINING BOO IN PATIENTS WITH BPH LUTS

2017 ◽  
Vol 24 (1) ◽  
Author(s):  
Pradana Nurhadi ◽  
Lukman Hakim ◽  
Tarmono Djojodimedjo ◽  
Sunaryo Hardjowijoto
Keyword(s):  
Outlet Obstruction ◽  
Area Ratio ◽  
Prostatic Hyperplasia ◽  
Exclusion Criteria ◽  
Non Invasive ◽  
Residual Urine ◽  
Urinary Tract Symptoms ◽  
The Mean ◽  
Insignificant Correlation ◽  
Lower Urinary

Objective: This study was conducted to determine the correlation between Presume Circle Area Ratio (PCAR) and IPSS score, Qmax, and post voiding residual urine (PVR) and to find PCAR cut-off value in determining the presence Bladder Outlet Obstruction (BOO) in Benign prostatic hyperplasia (BPH) Lower Urinary Tract Symptoms (LUTS). Materials & Methods: This study was observational analytic study with 30 BPH LUTS patients as subjects during the period September 2015 to January 2016. The determined variables were PCAR, IPSS score, Qmax, post voiding residual urine (PVR) and analyzed using the SPSS program v21. Results: There were 30 patients who met the inclusion and exclusion criteria with the mean age of 67.47 years. In the correlation test, there was insignificant correlation between PCAR with IPSS (r=0.138, p=0.467), a significant correlation between PCAR with Qmax (r=0.468, p=0.009), PCAR with PVR (r=0.399, p=0.029), PCAR with BOO (r=0.491, p=0.006) PCAR cutoff value is 0.65 with sensitivity of 69% and specificity of 71%. Conclusion: PCAR has a significant correlation with PVR, Qmax and BOO but no significant with IPSS score. PCAR value >0.65 indicating BOO in BPH LUTS. PCAR can be used as an alternative non-invasive examination in determining the existence of BOO.

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 Correlation between lower urinary tract symptoms and objective measures of uroflowmetry

2017 ◽  
Vol 89 (2) ◽  
pp. 130
Author(s):  
Hakan Türk ◽  
Sıtkı Ün
Keyword(s):  
Erectile Dysfunction ◽  
Clinical Symptoms ◽  
Outlet Obstruction ◽  
Prostate Hyperplasia ◽  
Non Invasive ◽  
Included Patient ◽  
Study Results ◽  
Symptom Scores ◽  
Diagnostic Panel ◽  
Lower Urinary

Indroduction: Benign prostate hyperplasia (BPH) is the most commonly diagnosed benign adenoma which causes serious clinical symptoms by bladder outlet obstruction. BPH patients suffer from negative changes in their quality of life and restriction of their daily activities due to the disease symptoms. Our main objective in this study is to evaluate the relationship between BPH and LUTS as described by International Prostate Symptoms Score and objective non-invasive parameters related to BPH. Materials and methods: 238 Patients over 40 years with clinical BPH, LUTS and/or prostate volumes greater than 25 ml who presented to urology department were included in the study. All patients included in the study were subjected to a standardized diagnostic panel which included patient history, physical examination, biochemistry panels and urinalysis. Results: Results showed an increase in symptom scores with age. As symptom scores go from mild to severe; Qmax values showed a decrease meanwhile prostate volume, PSA and postvoid residue increased. Again, in terms of erectile dysfunction, erectile dysfunction complaints increased with increased IIEF symptom scores. When all these results were evaluated, a positive correlation was seen between uroflowmetry parameters with patient symptoms, PSA and IIEF scores. Conclusion: From our study results, we can conclude that uroflowmetry is a very useful tool in monitoring lower urinary system complaints.

1256 EFFICACY OF DUTASTERIDE FOR RELIEVING BLADDER OUTLET OBSTRUCTION: A PROSPECTIVE PRESSURE-FLOW STUDY

2012 ◽  
Vol 187 (4S) ◽  
Author(s):  
Naoki Wada ◽  
Seiji Matsumoto ◽  
Masafumi Kita ◽  
Kazumi Hashidume ◽  
Hidehiro Kakizaki
Keyword(s):  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Pressure Flow ◽  
Pressure Flow Study ◽  
Flow Study

Ultrasound Assessment of Detrusor Thickness in Men—Can it Predict Bladder Outlet Obstruction and Replace Pressure Flow Study?

2006 ◽  
Vol 175 (6) ◽  
pp. 2170-2173 ◽  
Author(s):  
Thomas M. Kessler ◽  
Rolf Gerber ◽  
Fiona C. Burkhard ◽  
Urs E. Studer ◽  
Hansjörg Danuser
Keyword(s):  
Bladder Outlet Obstruction ◽  
Outlet Obstruction ◽  
Pressure Flow ◽  
Pressure Flow Study ◽  
Ultrasound Assessment ◽  
Flow Study

Urodynamic study for distinguishing multiple system atrophy from Parkinson disease

Neurology ◽  
2019 ◽  
Vol 93 (10) ◽  
pp. e946-e953 ◽  
Author(s):  
Jung Hyun Shin ◽  
Kye Won Park ◽  
Kyeong Ok Heo ◽  
Sun Ju Chung ◽  
Myung-Soo Choo
Keyword(s):  
Multiple System Atrophy ◽  
Parkinson Disease ◽  
Sensitivity And Specificity ◽  
Flow Rate ◽  
Detrusor Overactivity ◽  
Urodynamic Study ◽  
Maximal Flow ◽  
Postvoid Residual ◽  
Pressure Flow Study ◽  
Flow Study

ObjectiveTo evaluate the differences in urodynamic findings between multiple system atrophy (MSA) and Parkinson disease (PD) and to identify the differential diagnostic ability of urodynamic study.MethodsWe reviewed patients with MSA or PD who underwent urodynamic studies between January 2011 and August 2018. Patients with probable MSA and PD determined by movement disorder specialists at our center were included. Patients with alleged MSA or PD from outside hospitals, atypical or secondary parkinsonism, and any history of pelvic operation or radiation therapy were excluded.ResultsA total of 219 patients, 107 with MSA (male:female 50:57) and 112 with PD (male:female 57:55), were included. Patients with MSA had shorter disease duration and were referred for urologic evaluation earlier (p < 0.001). Detrusor overactivity and associated urine leakage were prominent in PD (p < 0.001). Patients with MSA showed lower maximal flow rate (4.0 ± 5.8 vs 9.1 ± 8.3 mL/s, p < 0.001) and larger postvoid residual (290.8 ± 196.7 vs 134.0 ± 188.1 mL, p < 0.001) with decreased compliance (44.9% vs 10.7%, p < 0.001) and impaired contractility (24.9 ± 33.8 vs 65.7 ± 51.1, p < 0.001). Postvoid residual from a pressure-flow study had the highest sensitivity and specificity (74.8% and 75.9%), followed by detrusor pressure at maximal uroflow (72.6% and 70.5%), bladder contractility index, and postvoid residual from uroflowmetry (71.0% and 70.5%, respectively).ConclusionsPatients with MSA showed lower maximal flow rate, larger postvoid residual with decreased compliance, and impaired contractility, whereas patients with PD had higher incidence of detrusor overactivity and associated leakage. For differential diagnosis, postvoid residual from a pressure-flow study provided the best sensitivity and specificity.Classification of evidenceThis study provides Class III evidence that urodynamic measures can distinguish patients with MSA from those with PD.

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