Differences between the data from free flow and intubated flow in women with urinary incontinence. What do they mean?

Valentini, Françoise; Marti, Brigitte; Robain, G.; Nelson, Peter G.

doi:10.1002/nau.20518

Cited by 12 publications

(9 citation statements)

References 14 publications

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“…Finally, 2 recent studies on this subject confirmed these previous findings. 17,18 On the contrary, Lose and colleagues reported no difference between the Q max of 60 symptomatic women when two 5 Fr catheter were used simultaneously. 19 However, voided volume was significantly higher during the PFS than during the NIFFS.…”

Section: Discussionmentioning

confidence: 98%

The effect of a 6 Fr catheter in women: Are they obstructive?

Richard

Ordonez

2013

CUAJ

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Objectives: Our objective was to evaluate the effect of a 6 Fr transurethral catheter on the uroflowmetry and to assess whether it potentially contributes to the bladder outlet obstruction (BOO) in women. Methods: We reviewed the charts of 1367 women who underwent an urodynamic study. We included patients with a non-invasive free-flow study (NIFFS) and pressure flow study (PFS) performed through a 6 Fr double lumen transurethral catheter. Results: In total, 120 women met the inclusion/exclusion criteria. Mean maximal flow rate (Q max ) was significantly higher (p < 0.001) in the NIFFS (27.2±11.1 mL/s) than in the PFS (19.3±10.6 mL/s). The mean difference between both Q max was 7.9±12.0 mL/s. Of these women, 92.3% (24/26) with a Q max <12 mL/s during PFS were found to have a Q max ≥12 mL/s during the NIFFS. Ten of the 72 women with an available P det. Q max were deemed to have a BOO according to the PFS and all of them had a Q max >12 mL/s during the NIFFS. Of the 10 patients, only 2 reported obstructive symptoms. Conclusion: The presence of 6 Fr transurethral catheters alters the PFS and results in a significant reduction of the Q max in patients who voided more than 250 mL. We believe that NIFFS should be performed in all patients before any urethral manipulation to lower a possible overdiagnosis of BOO and findings should always be correlated to clinical symptoms.

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Section: Discussionmentioning

confidence: 98%

The effect of a 6 Fr catheter in women: Are they obstructive?

Richard

Ordonez

2013

CUAJ

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“…Some results have been obtained: (1) correlation of the VBN parameter pucp (prostatic urethral counter-pressure) with the Abrams-Griffiths number, obstructive coefficient (OCO) and urethral resistance factor (URA) [2]; (2) creation of the VBN parameter k for detrusor contractility with both a modified projected isometric value (PIP) and the Watt factor [2]; (3) definition of an index of voiding dysfunction (D) for patients with BPE [7]; (4) demonstration of the effect of a urethral catheter on voiding [8]; (5) assessment of an alpha-blocker treatment for BPE and of surgery for incontinence with suburethral tapes [9].…”

Section: Initial Vbn Modelmentioning

confidence: 99%

Can Modeled Analysis of Urodynamic Recordings Help to Demonstrate the Nervous Control of the Bladder and Urethra During Micturition?

Valentini¹,

Mazieres²,

Nelson³

2010

UIJ

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PVR = postvoid residual Q, Q max = flow rate, maximum flow rate T = time constant V, V u , V ini = bladder volume, voided volume, initial bladder volume VBN = Valentini, Besson, Nelson W = ratio of active regulatory protein ABSTRACT INTRODUCTION: The purpose of the study was to build and test a mathematical model that allows new information about efferent neural activity for the bladder and sphincter to be extracted from urodynamic recordings during the micturition cycle. METHODS: The main features of the VBN micturition model were reviewed. An extended VBN model that includes a more detailed model of nervous control was then described. The mean firing rate F(t) of efferent neurons was linked first to an effective calcium excitation E(t) in the muscle cells and then to the detrusor and urethral pressures. Finally, this model was used to retrospectively analyze urodynamic recordings of 166 male and female patients with various voiding characteristics. RESULTS: The main result was the striking simplicity of the computed F(t) curves for both the detrusor and sphincter during the 3 phases of the micturition cycle (storage-continence, micturition, and return to continence). This result occurred in most of the micturitions: (1) normal with or without break of detrusor excitation, (2) abnormal with large residual volume, (3) abnormal with effect of a urethral catheter in situ. These curves F(t) were found as a sequence of constant values during the onset of flow and during the plateau phase, and then as a decreasing exponential during the return to continence phase. The transition between the 2 phases was always brisk, suggesting ON/OFF switching of reflexes. CONCLUSION: The extended VBN model for analyzing urodynamic recordings facilitates comparison and discussion of successive micturitions from a given patient and is a valuable complement to animal studies and to functional imaging of the human brain. UroToday International Journal ® UI J

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“…Direct interpretation is relatively limited using this formula compared with 89% interpretability for the Liverpool nomograms (15-600 mL). Valentini et al [5] recently noted that free (nonintubated) urofl owmetry studies should be used to interpret urofl ow and PVR parameters, as intubation urofl owmetry (pressure catheter in situ) is associated with a greater level of abnormality of both parameters.…”

Section: Defi Ning Abnormal Voiding Function In Womenmentioning

confidence: 99%

Female voiding dysfunction: Prevalence and common associations

Haylen

2009

Curr Urol Rep

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The understanding of voiding dysfunction has been greatly assisted by the current introduction of clear definitions for its diagnosis and for the abnormalities of urine flow rates and postvoid residuals that are its basis. Its prevalence in women with symptoms of pelvic floor dysfunction is up to 40%. Most of the recent research has centered on the associations of voiding dysfunction with age, pelvic organ prolapse, and prior continence surgery. The effects of parity, medications, and pelvic tumors have also been explored.

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Differences between the data from free flow and intubated flow in women with urinary incontinence. What do they mean?

Abstract: Significant differences were found between the data from a FF and an IF in women with urinary incontinence. These findings bring to the fore the impact of the transurethral catheter and underline the necessity to obtain at least one FF and one IF during a urodynamic session.

Cited by 12 publications

References 14 publications

The effect of a 6 Fr catheter in women: Are they obstructive?

The effect of a 6 Fr catheter in women: Are they obstructive?

Can Modeled Analysis of Urodynamic Recordings Help to Demonstrate the Nervous Control of the Bladder and Urethra During Micturition?

Female voiding dysfunction: Prevalence and common associations

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