2175 THE EFFECT OF A 6FR CATHETER ON PRESSURE-FLOW STUDIES IN WOMEN: ARE THEY REALLY OBSTRUCTIVE?

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Urodynamic Testing1 Apr 20112175 THE EFFECT OF A 6FR CATHETER ON PRESSURE-FLOW STUDIES IN WOMEN: ARE THEY REALLY OBSTRUCTIVE? Patrick Richard, Nydia Icaza Ordonez, and Le Mai Tu Patrick RichardPatrick Richard Sherbrooke, Canada More articles by this author , Nydia Icaza OrdonezNydia Icaza Ordonez Sherbrooke, Canada More articles by this author , and Le Mai TuLe Mai Tu Sherbrooke, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2412AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urodynamic studies (UDS) allow for direct assessment of the lower urinary tract symptoms (LUTS). The pressure-flow studies are one of the most important parameters evaluated during the UDS in order to determine if the patient is suffering from bladder outlet obstruction (BOO). There is currently no consensus on the definition of BOO in women but UDS criteria such as a maximal flow rate (Qmax) ≤ 15mL/s and a PdetQmax ≥ 20cm H2O is generally used. However, the use of transurethral catheters during the pressure-flow studies has brought up concerns about its potential obstructive nature which could result in false positive BOO diagnosis. Thus, the objective of this study is to evaluate the effect of a 6Fr transurethral catheter on pressure-flow studies and to evaluate whether it might potentially contributes to the obstruction. METHODS This is a retrospective study of 615 women referred for an evaluation of lower urinary tract symptoms and who underwent an urodynamic study. Non invasive free-flow uroflowmetry (UFM) was performed before every urodynamic studies and postvoiding residual urine volume (PVR) was recorded. Cystometrography (CMG) was then performed using a 6 Fr double lumen transurethral and PVR recorded at the end of the procedure. RESULTS The mean age of the population was 62±13 years old. The Qmax was significantly higher (p<0.001) in the free-flow studies [20.0mL/s (range 13.7–28.5)] than in the pressure-flow studies [17.5mL/s (range 11.8–25.2). This difference becomes even greater(−6mL/s) if we analyze only the patients (n=155) who voided a volume varying by less than 20% between the free and pressure-flow studies. Furthermore, 132 women (18%) in the overall population would have been misinterpreted as having an obstructive Qmax while the same can be said for 40 women (26%) in the sub-analyzed group if only the pressure-flow study would have been performed. CONCLUSIONS This study shed the light on how important is the flow-free study in the interpretation of the UDS. We believe that it should be performed in all patients before pressure-flow study because of the potential obstructive nature of the 6Fr catheters which could results in an erroneous diagnosis and unnecessary treatment. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e871-e872 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick Richard Sherbrooke, Canada More articles by this author Nydia Icaza Ordonez Sherbrooke, Canada More articles by this author Le Mai Tu Sherbrooke, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...