Pressure-flow nomogram for women with lower urinary tract symptoms

Dybowski, Bartosz; Bres-Niewada, Ewa; Radziszewski, Piotr

doi:10.5114/aoms.2014.44867

Cited by 16 publications

(14 citation statements)

References 15 publications

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“…While these indices are quantifiable in women using Qmax and Pdet@Qmax, they were originally described in male patients with varying grades of bladder outlet obstruction. Our findings are consistent with what has been previously reported in the literature, [23][24][25] and thus corroborate the poor applicability of these indices to female lower urinary tract physiology.…”

Section: Discussionsupporting

confidence: 93%

Urodynamic factors associated with the large capacity bladder and incomplete emptying after prolapse repair (2009‐2015)

Dobberfuhl

Shaffer

Goodman

et al. 2019

Neurourology and Urodynamics

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Aims To identify the clinical and urodynamic factors associated with the large capacity bladder and incomplete bladder emptying after prolapse repair. Methods We identified 592 women who underwent anterior and/or apical prolapse repair at our institution from 2009 to 2015. Women were stratified by urodynamic capacity. The primary outcome was incomplete emptying at the longest follow‐up (postvoid residual [PVR] > 200 mL). Data were analyzed in the Statistical Analysis System software. Results Two hundred and sixty‐six women (mean age, 61 years) had preoperative urodynamic tracings available for review. After surgery, there were 519 PVRs in 239 women recorded at up to 2949 days (mean, 396) and nine time points (median, 2; IQR, 1‐3). The receiver operator curve for predicted probability of longest follow‐up PVR greater than 200 mL (area under curve = 0.67) identified the 600 mL cutpoint which defined large capacity bladder. Large capacity bladders (capacity, >600 mL [n=79] vs ≤600 mL, [n=160]) had a mean: detrusor pressure at maximum flow (21 vs 22 cm H2O; P = 0.717), maximum flow rate (19 vs 17 mL/s; P = 0.148), significantly elevated PVR (202 vs 73 mL; P < 0.001), and significantly lower voiding efficiency (VE) (74 vs 82%, P < 0.05). Following prolapse repair, elevated PVR was associated with large capacity (PVR 101 vs 49 mL, P < 0.05). Large bladders had a two‐ to three‐fold risk of longest follow‐up PVR greater than 200 mL (14.3%‐20.3% [capacity, >600 mL] vs 4.1%‐7.0% [capacity, ≤600 mL]). VE was similar after surgery regardless of the capacity (87% vs 88%, P = 0.772). Conclusions The decision to pursue prolapse repair should be individualized and take into account, the bladder capacity and goals for PVR improvement after surgery.

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Section: Discussionsupporting

confidence: 93%

Urodynamic factors associated with the large capacity bladder and incomplete emptying after prolapse repair (2009‐2015)

Dobberfuhl

Shaffer

Goodman

et al. 2019

Neurourology and Urodynamics

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“…As to the respondents who did not complete the IPSS, the validated questionnaire is a time-consuming tool that offers little advantage in the treatment decision-making process. However, the accumulated evidence in the literature suggests that the IPSS is not a reliable diagnostic tool for LUTS, but serves merely as a measure of LUTS after the diagnosis is established [ 5 , 6 ]. Therefore, its significance in the management of men with LUTS cannot be underestimated.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and management of male lower urinary tract symptoms: treatment patterns and guidelines in a correlation study among Polish urology consultants

Borkowski¹,

Gołąbek²,

Chłosta³

et al. 2015

aoms

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IntroductionIn March 2013, the European Association of Urology (EAU) released a new edition of the guidelines on management of male lower urinary tract symptoms (LUTS), including benign prostatic obstruction. The objective of this study was to evaluate how well the EAU guidelines have been implemented in day-to-day practice by Polish urologists.Material and methodsA structured questionnaire, which explored how urologists diagnose and manage male lower urinary tract symptoms, was emailed to all certified, actively practicing urologists from a list provided by the Polish Urological Association.ResultsThe questionnaire return rate was 33.7% (135/400). Overall, the median (quartile 1; quartile 3) frequency of correct answers was 65.0% (58.0%; 69.0%). Analysis of the association of availability and acceptance of the EAU guidelines with question answers showed no pattern. A multivariate regression model showed a positive correlation with regards to correct answers given in the survey and doctors’ participation in international congresses (p = 0.018, r = 0.181). Basket analysis showed the strongest association for those who failed to correctly answer the questions regarding diagnosis of LUTS and overactive bladder (OAB) (support = 27.41%, confidence = 86.05%).ConclusionsAlthough there is a significant degree of adherence to the 2013 EAU guidelines, some discrepancies between urologists’ practice and the recommendations regarding diagnosis and treatment of male LUTS do exist. The data obtained provide valuable benchmarks and also identify possible interventions that may improve the standard of care in this population of patients.

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“…It is advisable to assess risk factors for UTI in pregnancy, bearing in mind that some diagnostic procedures are not feasible and advisable to perform i.e. urodynamic studies [ 93 ]. Unfortunately, in contrast to the overall population, available data are scant, and the management guidelines were published several years ago and were largely opinion-based.…”

Section: Future Challengesmentioning

confidence: 99%

State of the art paper Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems

Matuszkiewicz‐Rowińska¹,

Małyszko²,

Wieliczko³

2015

aoms

208

119

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Urinary tract infections (UTIs) are common in pregnant women and pose a great therapeutic challenge, since the risk of serious complications in both the mother and her child is high. Pregnancy is a state associated with physiological, structural and functional urinary tract changes which promote ascending infections from the urethra. Unlike the general population, all pregnant women should be screened for bacteriuria with urine culture, and asymptomatic bacteriuria must be treated in every case that is diagnosed, as it is an important risk factor for pyelonephritis in this population. The antibiotic chosen should have a good maternal and fetal safety profile. In this paper, current principles of diagnosis and management of UTI in pregnancy are reviewed, and the main problems and controversies are identified and discussed.

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Pressure-flow nomogram for women with lower urinary tract symptoms

Cited by 16 publications

References 15 publications

Urodynamic factors associated with the large capacity bladder and incomplete emptying after prolapse repair (2009‐2015)

Urodynamic factors associated with the large capacity bladder and incomplete emptying after prolapse repair (2009‐2015)

Evaluation and management of male lower urinary tract symptoms: treatment patterns and guidelines in a correlation study among Polish urology consultants

State of the art paper Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems

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