As a combined electrophysiological system for evaluating the lower urinary tract(LUT), comprehensive urodynamics(UDS) aims at duplicating patient's micturition process, either normal or abnormal, and further seeki...As a combined electrophysiological system for evaluating the lower urinary tract(LUT), comprehensive urodynamics(UDS) aims at duplicating patient's micturition process, either normal or abnormal, and further seeking for possible causative origin, either neurogenic or non-neurogenic, in order to guide treatment. Through thorough analysis, some so-called cutoff values, for example, bladder outlet obstruction(BOO) degree or dyssynergic degree between the detrusor and sphincter, could be gained; however, in most cases, their qualitative description, such as stress urinary incontinence, idiopathic detrusor underactivity(DUA), detrusor overactivity(IDO), low compliance, and idiopathic sphincter overactivity(ISO), is more preferable and important. In aged neurologically intact male patients with symptoms of the LUT(LUTS) including benign prostatic hyperplasia, a combined UDS system, which coupled BOO with compliance, was constructed. The patients may be categorized into one of the seven subgroups, including equivocal or mild BOO with sphincter synergia with or without IDO(pattern A), equivocal or mild BOO with ISO(B), classic BOO with sphincter synergia(C) or ISO(D), BOO with only low compliance(E), BOO with both DUA and low compliance(F), and potential BOO with DUA(G). This new system can be used to optimize diagnosis and treatment according to a derived guideline diagram.展开更多
Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynam...Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynamic studies in women over 18 years old conducted between May 2011 and November 2015. Patients with previous history of pelvic surgery or radiotherapy, neurological disease, vaginal prolapse greater than grade I, congenital urogenital malformations, urinary obstructive disease, diabetes, or the use of any medication that could interfere with bladder function were excluded from the analysis. The urodynamic parameters analyzed were the Maximum Cystometric Capacity (MCC), Voiding Volume (VV), Maximum Flow (Qmax), Bladder Compliance (BC), Detrusor Pressure at Maximum Flow (PdetQmax), Bladder Contractility Index (BCI), Bladder Voiding Efficiency (BVE) and Post-Void Residual Urine Volume (PVR). Patients were further stratified in five groups according to age (A—18 to 40;B—41 to 50;C—51 to 60;D—61 to 70;E—over 70 years old). Results: Out of 3103 urodynamic studies analyzed, 719 were eligible for the study. The average age of patients was 49.3 (+13.2) years old and in all evaluated parameters, statistically significant correlation between age and decline of bladder function was obtained (p Conclusions: This study showed a decline in bladder storage function (reduction in MCC and BC) and in bladder emptying function (reduction in Qmax, PdetQmax, VV, BCI and BVE with an increase in PVR) with age.展开更多
<strong>Objective:</strong> The objective is to evaluate autonomic dysreflexia (AD) severity between urodynamics and cystoscopy in patients with spinal cord injury (SCI) above thoracic 6 (T6). <strong&g...<strong>Objective:</strong> The objective is to evaluate autonomic dysreflexia (AD) severity between urodynamics and cystoscopy in patients with spinal cord injury (SCI) above thoracic 6 (T6). <strong>Design:</strong> It is a cross-sectional survey. <strong>Subject and methods: </strong>The study was carried out in 22 patients with SCI above T6 who underwent both procedures of urodynamics and cystoscopy;all patients developed episodes of AD. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured and recorded at the beginning and during the various stages of the two examinations. AD was defined as a rise in SBP above 20 mm Hg. <strong>Results: </strong>There was no significant difference in SBP and DBP at baseline before urodynamics and cystoscopy. Both urodynamics and cystoscopy triggered episodes of AD. The volume of water instilled during cystoscopy was typically standard and smaller (150 mL) in comparison with urodynamics, where volume varied depending on cystometric bladder capacity (the mean bladder volume in our study was 234.86 ± 139.06 mL). The SBP was significantly different between cystoscopy and urodynamics (49.23 ± 23.07 mm Hg and 35.14 ± 15.75 mm Hg, respectively;P = 0.023). <strong>Conclusions: </strong>Although bladder distension during cystoscopy was less than that in urodynamics, the severity of AD was more pronounced during cystoscopy. It is recommended that monitoring of cardiovascular parameters during these procedures should be routinely performed.展开更多
Objective:We sought to determine if urodynamic study(UDS)predicted voiding outcomes in men with detrusor underactivity(DU)and benign prostatic enlargement(BPE)who underwent photovaporization of the prostate(PVP).Metho...Objective:We sought to determine if urodynamic study(UDS)predicted voiding outcomes in men with detrusor underactivity(DU)and benign prostatic enlargement(BPE)who underwent photovaporization of the prostate(PVP).Methods:Between September 2010 and July 2015,106 male patients with BPE and DU were identified.All patients underwent PVP.Urinary retention was noted by the preoperative necessity for an indwelling or intermittent catheter.Data collection included comorbidities,quality of life(QoL)scores,prostate volume,prostate-specific antigen(PSA),UDS and perioperative outcomes.UDS parameters included volume at first desire to void,volume at first urge to void,volume of severe urge,volume at capacity,compliance,detrusor contractions,maximum urinary flow rate(Qmax),and postvoid residual(PVR).Results:A total of 106 men were included in this analysis,who had urinary retention with a Foley catheter or clean intermittent catheterization(CIC)at the time of surgery.At baseline we found patients who voided had a detrusor pressure at Qmax(Pdet@Qmax)of 10.05±6.45 cmH2O compared to 16.78±12.17 cmH2O in those who did not void(p=0.071).Postoperatively,96(90.6%,mean age 76.9±26.2 years)of patients voided successfully while 10(9.4%,mean age 80.52±9.61 years)of patients remained in urinary retention.Mean baseline Qmax was 4.895±5.452 mL/s and 2.900±3.356 mL/s(p=0.087)in those who voided and did not respectively.PVR was 319.23±330.62 mL in those who voided and 276.88263.27 mL(p=0.344)in those who did not void.No UDS parameter predicted who would void postoperatively or improvements in QoL.Conclusions:The patients with DU and BPE might be able to successfully void after undergoing PVP regardless of UDS findings.All men who voided had improved international prostate symptom score and QoL scores compared to baseline and these parameters were durable up to 12 months.展开更多
文摘As a combined electrophysiological system for evaluating the lower urinary tract(LUT), comprehensive urodynamics(UDS) aims at duplicating patient's micturition process, either normal or abnormal, and further seeking for possible causative origin, either neurogenic or non-neurogenic, in order to guide treatment. Through thorough analysis, some so-called cutoff values, for example, bladder outlet obstruction(BOO) degree or dyssynergic degree between the detrusor and sphincter, could be gained; however, in most cases, their qualitative description, such as stress urinary incontinence, idiopathic detrusor underactivity(DUA), detrusor overactivity(IDO), low compliance, and idiopathic sphincter overactivity(ISO), is more preferable and important. In aged neurologically intact male patients with symptoms of the LUT(LUTS) including benign prostatic hyperplasia, a combined UDS system, which coupled BOO with compliance, was constructed. The patients may be categorized into one of the seven subgroups, including equivocal or mild BOO with sphincter synergia with or without IDO(pattern A), equivocal or mild BOO with ISO(B), classic BOO with sphincter synergia(C) or ISO(D), BOO with only low compliance(E), BOO with both DUA and low compliance(F), and potential BOO with DUA(G). This new system can be used to optimize diagnosis and treatment according to a derived guideline diagram.
文摘Aim: To determine whether bladder functions deteriorate with age. Methods: Data contained in electronic medical record (INFOMED?) were used in this institutional retrospective review. Analysis was done on the urodynamic studies in women over 18 years old conducted between May 2011 and November 2015. Patients with previous history of pelvic surgery or radiotherapy, neurological disease, vaginal prolapse greater than grade I, congenital urogenital malformations, urinary obstructive disease, diabetes, or the use of any medication that could interfere with bladder function were excluded from the analysis. The urodynamic parameters analyzed were the Maximum Cystometric Capacity (MCC), Voiding Volume (VV), Maximum Flow (Qmax), Bladder Compliance (BC), Detrusor Pressure at Maximum Flow (PdetQmax), Bladder Contractility Index (BCI), Bladder Voiding Efficiency (BVE) and Post-Void Residual Urine Volume (PVR). Patients were further stratified in five groups according to age (A—18 to 40;B—41 to 50;C—51 to 60;D—61 to 70;E—over 70 years old). Results: Out of 3103 urodynamic studies analyzed, 719 were eligible for the study. The average age of patients was 49.3 (+13.2) years old and in all evaluated parameters, statistically significant correlation between age and decline of bladder function was obtained (p Conclusions: This study showed a decline in bladder storage function (reduction in MCC and BC) and in bladder emptying function (reduction in Qmax, PdetQmax, VV, BCI and BVE with an increase in PVR) with age.
文摘<strong>Objective:</strong> The objective is to evaluate autonomic dysreflexia (AD) severity between urodynamics and cystoscopy in patients with spinal cord injury (SCI) above thoracic 6 (T6). <strong>Design:</strong> It is a cross-sectional survey. <strong>Subject and methods: </strong>The study was carried out in 22 patients with SCI above T6 who underwent both procedures of urodynamics and cystoscopy;all patients developed episodes of AD. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured and recorded at the beginning and during the various stages of the two examinations. AD was defined as a rise in SBP above 20 mm Hg. <strong>Results: </strong>There was no significant difference in SBP and DBP at baseline before urodynamics and cystoscopy. Both urodynamics and cystoscopy triggered episodes of AD. The volume of water instilled during cystoscopy was typically standard and smaller (150 mL) in comparison with urodynamics, where volume varied depending on cystometric bladder capacity (the mean bladder volume in our study was 234.86 ± 139.06 mL). The SBP was significantly different between cystoscopy and urodynamics (49.23 ± 23.07 mm Hg and 35.14 ± 15.75 mm Hg, respectively;P = 0.023). <strong>Conclusions: </strong>Although bladder distension during cystoscopy was less than that in urodynamics, the severity of AD was more pronounced during cystoscopy. It is recommended that monitoring of cardiovascular parameters during these procedures should be routinely performed.
文摘Objective:We sought to determine if urodynamic study(UDS)predicted voiding outcomes in men with detrusor underactivity(DU)and benign prostatic enlargement(BPE)who underwent photovaporization of the prostate(PVP).Methods:Between September 2010 and July 2015,106 male patients with BPE and DU were identified.All patients underwent PVP.Urinary retention was noted by the preoperative necessity for an indwelling or intermittent catheter.Data collection included comorbidities,quality of life(QoL)scores,prostate volume,prostate-specific antigen(PSA),UDS and perioperative outcomes.UDS parameters included volume at first desire to void,volume at first urge to void,volume of severe urge,volume at capacity,compliance,detrusor contractions,maximum urinary flow rate(Qmax),and postvoid residual(PVR).Results:A total of 106 men were included in this analysis,who had urinary retention with a Foley catheter or clean intermittent catheterization(CIC)at the time of surgery.At baseline we found patients who voided had a detrusor pressure at Qmax(Pdet@Qmax)of 10.05±6.45 cmH2O compared to 16.78±12.17 cmH2O in those who did not void(p=0.071).Postoperatively,96(90.6%,mean age 76.9±26.2 years)of patients voided successfully while 10(9.4%,mean age 80.52±9.61 years)of patients remained in urinary retention.Mean baseline Qmax was 4.895±5.452 mL/s and 2.900±3.356 mL/s(p=0.087)in those who voided and did not respectively.PVR was 319.23±330.62 mL in those who voided and 276.88263.27 mL(p=0.344)in those who did not void.No UDS parameter predicted who would void postoperatively or improvements in QoL.Conclusions:The patients with DU and BPE might be able to successfully void after undergoing PVP regardless of UDS findings.All men who voided had improved international prostate symptom score and QoL scores compared to baseline and these parameters were durable up to 12 months.
