Novel Natural Fill Telemetric Pressure Flow Study of Discomfort and Bladder Outlet Obstruction

Abstract

We evaluated the accuracy of natural fill telemetric pressure flow study performed in a private room, and assessed patient discomfort and experience after the procedure compared to those of standard pressure flow study. In 58 patients with lower urinary tract symptoms/benign prostatic hyperplasia free uroflowmetry, and natural fill telemetric and standard pressure flow studies were prospectively performed. Immediately after each step patients were asked to rate the experience in terms of pain, embarrassment, bother, boredom and repeat testing. Subjective items and objective urodynamic parameters were compared among the 3 tests. Maximum urine flow on natural fill telemetric pressure flow study was not different from that on free uroflowmetry. In contrast, maximum flow, detrusor pressure at maximum flow and bladder contractility index on the standard pressure flow study were significantly lower than on the natural fill pressure flow study. However, the bladder outlet obstruction index was not significantly different between the 2 studies, and the bladder outlet obstruction and bladder contractility indexes correlated well. There were also no differences in bother and embarrassment scores. However, natural fill telemetric pressure flow study was superior in terms of pain and boredom scores. Patients were more willing to undergo repeat natural fill telemetric pressure flow study than standard pressure flow study. Time to complete the test was significantly shorter for the natural fill study than for the standard study. Flow rate differences between pressure flow studies and free uroflowmetry are not due to mechanical obstruction by the catheter but to other factors, such as the bladder filling method. Objective parameters on the natural fill telemetric pressure flow study correlated with standard pressure flow study findings. The natural fill telemetric pressure flow study shortened the time needed for the test and may decrease the discomfort of the standard pressure flow study.