You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Non-Neurogenic Voiding Dysfunction1 Apr 20121962 DECREASE OF MAXIMUM FLOW RATE DURING INTUBATED FLOW COULD BE THE CONSEQUENCE OF A URETHRAL REFLEX Françoise Valentini, Gilberte Robain, Dorothée Hennebelle, Pierre Nelson, and Philippe Zimmern Françoise ValentiniFrançoise Valentini Paris, France More articles by this author , Gilberte RobainGilberte Robain Paris, France More articles by this author , Dorothée HennebelleDorothée Hennebelle Paris, France More articles by this author , Pierre NelsonPierre Nelson Paris, France More articles by this author , and Philippe ZimmernPhilippe Zimmern Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2121AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To use the VBN mathematical micturition model [1] to analyze the potential obstructive effect of the transurethral catheter on the voiding process during intubated flow (IF). Our hypothesis was that an incomplete sphincter relaxation leads to a residual sphincter pressure (RSP). METHODS We reviewed a urodynamic database of women referred for the evaluation of lower urinary tract dysfunction. Criteria of exclusion were a neurological disease or grade ≥2 prolapse. Eligible women underwent a free uroflow (FF1) before cystometry, an IF (7F urethral catheter), and a second FF (FF2) at the end of the session. Interpreted flows were restricted to voided volumes ≥100 ml and continuous flow patterns. Analysis of FF and IF was made using the VBN model. Criteria for acceptable result: same value of the mechanical parameters during the session and fitting between recorded and computed curves with a quadratic error less than 5%. RESULTS Among 472 women, 157 met the criteria for inclusion. Effect of the urethral catheter was only a geometrical one in 60 (38.2%) files with QmaxIF close to QmaxFF1. An additional effect of the urethral catheter identified as an incomplete sphincter relaxation was observed in 97 (61.9%) files with QmaxFF1≥1.5*QmaxIF (Fig a,b). The ratio RSP/maximum urethral closure pressure was 0.39±0.25. Among this second group, the same RSP was found for 30 (30.97%) during FF2 (Fig b). CONCLUSIONS When comparing IF with FF1 using the VBN model, the decrease in Qmax did not appear to result from the mechanical effect of the catheter but from an incomplete sphincteric relaxation during voiding, possibly because of patient's anxiety or a urethral reflex induced by the presence of the catheter. These findings underscore the need to perform a FF before the IF to strengthen the reliability of the conclusions of a urodynamic investigation. %1-NAU 2000; 19 %153-76 © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e791-e792 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Françoise Valentini Paris, France More articles by this author Gilberte Robain Paris, France More articles by this author Dorothée Hennebelle Paris, France More articles by this author Pierre Nelson Paris, France More articles by this author Philippe Zimmern Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...