PD24-04 NON INVASIVE VELOCITY-FLOW VIDEOURODYNAMICS USING DOPPLER ULTRASONOGRAPHY DETECTION OF PERIODIC DETRUSOR ARREST DURING MICTURITION IN MEN UNDERACTIVE BLADDER SYNDROME

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence: Evaluation (Urodynamic Testing)1 Apr 2015PD24-04 NON INVASIVE VELOCITY-FLOW VIDEOURODYNAMICS USING DOPPLER ULTRASONOGRAPHY DETECTION OF PERIODIC DETRUSOR ARREST DURING MICTURITION IN MEN UNDERACTIVE BLADDER SYNDROME Hideo Ozawa, Michael Chancellor, Atsushi Nagai, and Hiromi Kumon Hideo OzawaHideo Ozawa More articles by this author , Michael ChancellorMichael Chancellor More articles by this author , Atsushi NagaiAtsushi Nagai More articles by this author , and Hiromi KumonHiromi Kumon More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1459AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Underactive bladder syndrome (UAB) is urological condition characterized by bladder underactivity causing difficulty in voiding, resulting in incomplete bladder emptying. To assess the urodynamic function of patients with UAB, this study compares velocity-flow relation among patients with subjective voiding dysfunction. METHODS Sixty-six consecutive men with symptomatic voiding dysfunction (IPSS > 20) underwent transperineal Doppler urodynamics. Subjects were separated in BPE group (Prostate size>30cm3: n=21; age 72), in UAB group (Intermittent velocity curve peak observed: n=15; age 69) and miscellaneous group (n=30; age 65). In the lavatory chair, an ultrasound transducer (Prosound α6, Hitachi Aloka Med) was adjusted transperineally using robotic manipulator. Doppler ultrasound images were recorded during voiding. Urine velocities in distal prostatic urethra (V1) and at the membranous urethra (V2) were calculated and resulting graph can be seen on the monitor. A conversion on each measured velocity obtained from Doppler ultrasound waves were performed to produce the tangential velocity of the actual micturition flow. RESULTS Qmax in BPE group (7.5ml/s) was found to be significantly lower than that of UAB group (9.6ml/s) and miscellaneous group (11.1ml/s). V1 (40.4cm/s) was relatively larger than V2(43.2cm/s) for the BPE group, whereas for miscellaneous group V2(63.4 cm/s) was significantly larger than V1(35.9cm/s). Since for most of the BPE patients prostatic urethra was the narrowest and the fastest part of the urethra, velocity decreased along the sphincter. For UAB group, intermittent peaks in velocity curve and rising trend in flow rate curve were simultaneously observed (Figure 1). In most of the cases, peaks in V2 (69.3 cm/s) were larger than those in V1 (40.0cm/s), which suggest the absence of bladder outlet obstruction. This phenomenon could represent the periodic arrest of detrusor contraction during voiding. CONCLUSIONS We have demonstrated for the first time that non invasive velocity-flow urodynamics using Doppler ultrasound can assess velocity of flow in prostatic and membranous uretha region and aid in diagnosis of intermittent detrusor arrest for patients with underactive bladder syndrome. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e487 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hideo Ozawa More articles by this author Michael Chancellor More articles by this author Atsushi Nagai More articles by this author Hiromi Kumon More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...