MP02-19 CLINICAL EPIDEMIOLOGY OF PRESSURE FLOW STUDY RESULTS IN WOMEN; NORMAL VALUES, GRADING OF CONTRACTION AND BLADDER OUTFLOW OBSTRUCTION AND ASSOCIATIONS WITH AGE AND PVR

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction I (MP02)1 Sep 2021MP02-19 CLINICAL EPIDEMIOLOGY OF PRESSURE FLOW STUDY RESULTS IN WOMEN; NORMAL VALUES, GRADING OF CONTRACTION AND BLADDER OUTFLOW OBSTRUCTION AND ASSOCIATIONS WITH AGE AND PVR Peter Rosier, and Phillip Smith Peter RosierPeter Rosier More articles by this author , and Phillip SmithPhillip Smith More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001963.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Analysis of female voiding is underappreciated, yet critical to understanding disorders of urine storage and voiding. Clinical epidemiology of voiding parameter values in women is however scarce. We report an analysis of urodynamic pressure flow (p/Q) studies in symptomatic women. METHODS: Retrospective review of urodynamic studies conducted in all women tested between 2010 and 2020. Analyzed studies were those for non-neurogenic dysfunction in patient able to void during standard urodynamic testing. PVR and p/Q parameters were assessed after pressure peaks and flowrate correction. Calculations included BCI and WFmax to assess detrusor output and BOOI and URA for the urethral resistance. BCI includes ‘k’ which is 5 in the usual (ICS) formula; pdetQmax+5Qmax, we added k=1 (BCI k=1) and BCI k=10 to the database to reduce or augment the influence of flowrate in the formula because BCI k=1 is reported to be more consistent with isovolumic maximum pressure in women. Association of p/Q (contraction) parameters with age and PVR is shown in boxplots, correlations are calculated. RESULTS: A total of 1260 studies were analyzed. Mean age was 50.7y (SD 17.5). Indications were: SUI 8%; UUI 13%; MUI 42%; OAB 15%; voiding symptoms 10% & other (12%). P/Q parameters were: Qmax 18.1 (2.5-71.7) mL/s; PdetQmax 26.7 (-10-199) cmH2O; URA (outflow resistance) 12.7 (0.03-87.5) cmH2O; BOOI 12.5 (-134-155); Wmax 11.6 (0.8-20.9); BCI 117.2 (10.7-400) (cmH2O). Obstruction was suggested in 36 (2.9%) by a BOOI >40 and 6.5% according to BOOI >30. Detrusor underactivity was suggested in 35.6% (BCI K5) and 23.1% had PVR >80mL. Fig. shows the association of PVR and contractility with age. ROC analysis shows AUC of 0.730 and 0.752 for BCI and Qmax to predict PVR (>80mL) and 0.822 for Wmax. Changing k in BCI to 1 reduces AUC to .620 and changing k to 10 results in AUC .745. PVR is (weakly) correlated with age r.194 (p.000); Qmax -,328 (p.000); BCI -,247 (p.000); Wmax -,202 (p.000); BOOI,168 (p.000) and URA, 242 (p.000). CONCLUSIONS: We report an analysis of pressure flow results in a large cohort of symptomatic women. BOO is rare; contractility can be assessed with Wmax and BCI. These are sensitive to predict PVR. Contractility trends downward and PVR upward with advancing age. Source of Funding: Department funded © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e19-e20 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter Rosier More articles by this author Phillip Smith More articles by this author Expand All Advertisement Loading ...