Abstract
To determine whether there are differences in pressure and flow measurements between conventional cystometry (CONV) and ambulatory urodynamic monitoring (AMB) in women with overactive bladder syndrome and urinary incontinence. Retrospective study which included female subjects who underwent both CONV (with saline filling medium) and AMB, separated by less than 24 months, not using medication active on the lower urinary tract and without history of prior pelvic surgery. Both tests were carried out in compliance with the International Continence Society standards. The paired Student's t test was used to compare continuous variables. Bland-Altman statistics were used to assess the agreement of each variable between both studies. Thirty women with a median (range) age of 50 (14 - 73) years met the inclusion criteria. AMB was carried out at a mean (SD) of 11 (6) months after CONV. Measurements of pves and pabd at the end of filling, and Qmax were significantly higher from AMB recordings. There were no differences in pdet at the end of filling, pdetQmax or pdetmax during voiding, nor significant difference in Vvoid. We provide previously undocumented comparative voiding data between CONV and AMB for patients who most commonly require both investigations. Our findings show higher values of Qmax but similar values of pdetQmax measured by AMB which may partly reflect an overall lower catheter caliber, physiological filling but perhaps also more 'normal' voiding conditions.
Highlights
Ambulatory urodynamic monitoring (AMB) with natural filling is a useful additional test for patients with lower urinary tract symptoms that cannot be explained by findings from a conventional cystometry (CONV) with non--physiological filling [1]
We identified 30 women being investigated for overactive bladder syndrome and urinary incontinence who met the inclusion criteria, whose urinary incontinence could not be categorized by CONV
The median number of voids analyzed from ambulatory urodynamic monitoring (AMB) was 2 with 9 (10%) of a total of 86 voids being excluded from measurement due to bladder line displacement (n=5) or Vvoid < 150 mL (n=4)
Summary
Ambulatory urodynamic monitoring (AMB) with natural filling is a useful additional test for patients with lower urinary tract symptoms that cannot be explained by findings from a conventional cystometry (CONV) with non--physiological filling [1]. Ambulatory urodynamic monitoring (AMB) with natural filling is a useful additional test for patients with lower urinary tract symptoms that cannot be explained by findings from a conventional cystometry (CONV) with non-. Pressure measurements during AMB are generally obtained using catheter-mounted microtip transducers positioned in the bladder and rectum rather than air or fluid filled lines connected to external transducers. These allow greater mobility but are more prone to artifact. Allowing the patient to be mobile is a key feature of AMB but the frequent changing of position alters the relative height of the rectal and bladder transducers making frequent signal quality control during bladder filling necessary. The previous lack of simultaneous uroflow recording during AMB which hampered interpretation of the voiding phase has been corrected in current devices that include this facility [4,5]
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