Comparison of Pressure/Flow Studies with Micturitional Urethral Pressure Profiles in the Diagnosis of Urinary Outflow Obstruction

Abstract

Computer technology has made it possible significantly to improve the technique and interpretation of the micturitional urethral pressure profile (MUPP). Thirty-nine patients with lower urinary tract symptoms have been investigated by this technique and the results compared with those of standard pressure/flow studies. A good correlation was found between the two methods of diagnosing outflow obstruction, but micturitional urethral pressure profiles offered practical advantages in patients who were elderly, immobile or who had severe involuntary voiding, and diagnostic advantages in patients with absent or poor detrusor contractility and those with equivocal pressure/flow studies.

Implications of the Most Bothersome Prostatism Symptom for Clinical Care and Outcomes Research

“…We used both criteria because reliable voiding profilometry data were obtained for every patient, whereas interpretable pressure‐flow data were not, as is often the case 36,37 . Furthermore, the profilometry and pressure‐flow diagnoses of obstruction correlate very closely 37–40 . In cases that were “equivocally obstructed” with the Abrams‐Griffiths nomogram, we relied on profilometry and Schäfer's linear passive urethral resistance relation (PURR) 35 to determine whether obstruction was present.…”

Is There a Role for Micturitional Urethral Pressure Profilometry in the Evaluation of Voiding Dysfunction in the 21st Century?

“…In a series of publications, the same authors and others described its role in the diagnosis of bladder neck obstruction, prostatic obstruction, detrusor-sphincter dyssynergia, and BOO in women [7][8][9][10]. Desmond and Ramayya [11] and later DuBeau et al [12] from Yalla's group described the method of dynamic micturitional urethral pressure profile (MUPP) and confirmed its utility in the diagnosis and quantification of BOO.…”

“…The most proximal site of the P clos denotes the most proximal site of obstruction. The amount of pressure gradient is proportional to the degree of obstruction [11,12]. In men, unlike women, a physiologic pressure drop of The original method of Yalla et al [6], in which the catheter had been pulled manually, can now be performed more precisely at predetermined and modifiable rates using a motorized automated puller device.…”

“…Initially, the urethral pressure aperture of the catheter is kept at the proximal end of urethral pressure profile, which is marked by a rise in urethral pressure over vesical pressure. Once the voiding is initiated and established, the catheter is pulled at a fixed rate to measure the voiding profile all along [11]. We use the same method for most of our patients.…”

Quantification of Bladder Outlet Obstruction by Measurement of Urethral Opening Pressure Using an Adapted Fluid Bridge Test

“…In the unobstructed male the bladder neck opens widely, there is no recordable pressure drop across the bladder neck, (Yalla et al, 1980;Desmond and Ramayya, 1987) and the flow controlling zone is in the region of the distal sphincter (Griffiths, 1980). In patients with bladder neck obstruction the bladder neck fails to open fully and there is a recordable pressure drop across the bladder neck during voiding (Desmond and Ramayya, 1988).…”