Noninvasive Measurement of Bladder Pressure by Controlled Inflation of a Penile Cuff

Abstract

The new method provides noninvasive quantitative information on voiding bladder pressure in males. Further study is required to assess whether the technique can contribute to the management of lower urinary tract symptoms.

Non‐invasive urodynamics predicts outcome prior to surgery for prostatic obstruction

“…The clinical question that must be addressed prior to initiating treatment is whether the symptoms can be attributed to bladder outlet obstruction or whether they are secondary to a poorly contractile detrusor muscle [2][3][4]. Men who do not receive adequate symptomatic benefit from the medical therapies are likely to be offered disobstructive prostatic surgery [5] -in our institution, by way of transurethral resection of the prostate (TURP) or Holmium laser enucleation of the prostate (HoLEP) [6,7].…”

Perineal noise recording as a non‐invasive diagnostic method of urinary bladder outlet obstruction: a study in polyvinyl alcohol and silicone model urethras

“…The transurethral catheters used for such a pressure £ow study induce the risk of urinary tract infection and urethral trauma [Klingler et al, 1998;Porru et al, 1999]. Recently, non-invasive (and more patient friendly) measurement techniques have been developed and tested to diagnose bladder outlet obstruction in patients with lower urinary tract symptoms: the Doppler £owmetry method [Ding et al, 2000], the condom-catheter method [Pel and van Mastrigt, 2001] and the cu¡ method [Gri⁄ths et al, 2002]. Another non-invasive measurement technique may be based on urethral noise recording.…”

Noninvasive Methods to Evaluate Bladder Obstruction in Men

“…When the outlet is occluded, a measurable isovolumetric pressure increase may be recorded. Comparisons have been made between pressure-flow studies, external catheter bladder pressure, and flow rate (Q max ) (41). In one study, 30% of patients would be correctly categorized as obstructed or non-obstructed based on flow rate (Q max ) alone.…”

“…A cuff is occluded around the urethra prior to voiding, then released to allow voiding and measure the pressure (40,41,43). A cuff fitted around the penile shaft is inflated to 250 cmH2O, then the subject in instructed to void against the occluded urethra.…”

“…A cuff fitted around the penile shaft is inflated to 250 cmH2O, then the subject in instructed to void against the occluded urethra. When the bladder contracts, an isovolumetric column of urine forms between the bladder and cuff, and the pressure is transmitted down to the occluding cuff (41,43). Once a column of urine is formed, the patient slowly releases pressure from the cuff, allowing it to deflate until flow is initiated through the cuff.…”