The mechanical stop test and isovolumetric detrusor contractile reserve are associated with immediate spontaneous voiding after transurethral resection of prostate

Dobberfuhl, Amy D.; Zhang, Xinyuan; Comiter, Craig V.

doi:10.1007/s11255-019-02322-y

Cited by 3 publications

(6 citation statements)

References 19 publications

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“…Indeed, as the study was about the influence of the filling volume, the bladder volume at the time of the stop‐tests had to be perfectly controlled. Most studies performed the stop‐test in the middle of micturition, which may complicate the comparison of results 7 . Finally, the order of filling volumes was not randomized and the stop‐tests were always performed in the same order.…”

Section: Discussionmentioning

confidence: 99%

“…Most studies performed the stop‐test in the middle of micturition, which may complicate the comparison of results. 7 Finally, the order of filling volumes was not randomized and the stop‐tests were always performed in the same order. It has been suggested that the repetition of the measurements could lead to detrusor fatigue and therefore a decrease in the observed contractility, 2 but the initial increase observed at 75% does not support this hypothesis and because of the relatively small number of measurements, the impact on the results is probably small.…”

Section: Discussionmentioning

confidence: 99%

“…Detrusor contractility was measured by the stop‐test technique, consisting in measuring the bladder pressure during a voluntary restraint effort just after the initiation of micturition 7 . This pressure corresponds to the maximum isometric detrusor pressure, representative of the detrusor contractile power.…”

Section: Methodsmentioning

confidence: 99%

“…5,6 Detrusor contractility was measured by the stop-test technique, consisting in measuring the bladder pressure during a voluntary restraint effort just after the initiation of micturition. 7 This pressure corresponds to the maximum isometric detrusor pressure, representative of the detrusor contractile power. The stop-test was repeated at three filling volumes, corresponding to 50%, 75%, and 100% of the bladder capacity measured during the initial cystometry.…”

Section: Data Collectedmentioning

confidence: 99%

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Effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction

Hermieu

Chesnel

Teng

et al. 2022

Neurourology and Urodynamics

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Introduction: Bladder outlet obstruction alters detrusor contractility, reducing the bladder's ability to respond to large filling with a risk of urinary retention. The objective was to assess the effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction.Methods: A prospective multicenter study in two pelviperineology departments. Male patients eligible for urodynamics (IPSS score > 7) were included from January to July 2022. In case of absence of bladder outlet obstruction on pressure-flow studies, they were secondarily excluded. The primary endpoint was the maximum isometric detrusor pressure during a stop-test, corresponding to detrusor contractility, measured at 3 filling volumes (50%, 75%, and 100% of cystometric capacity).Results: Fifty-two patients performed urodynamics, of whom 12 were excluded because of lack of obstruction or inability to perform the stop-test. Detrusor contractility was significantly higher for a 75% bladder filling than 50% and for a 75% filling than 100%, with a mean difference of 19.5; confidence interval (CI) 95% [14.3; 24.8] and 12.2; CI 95% [6.9; 17.5] cmH 2 O respectively (p < 0,01). Conclusion:In case of bladder outlet obstruction in men, detrusor contractility depends on bladder filling volume, with reduced contractility when the bladder was underfilled or overfilled. This phenomenon could help to explain the mechanisms of urinary retention in men with bladder outlet obstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Data Collectedmentioning

confidence: 99%

See 2 more Smart Citations

Effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction

Hermieu

Chesnel

Teng

et al. 2022

Neurourology and Urodynamics

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“…The mechanical stop test is an easy way to measure isovolumetric detrusor contractile pressure and detrusor contractile reserve [ 26 ] in men considering sling placement. For women, the effect of a sling can be simulated with the Marshall-Marchetti test.…”

Section: Discussionmentioning

confidence: 99%

The evolution of incontinence into resolved, refractory and de novo urgency urinary incontinence following sling placement at time of prolapse repair in a large urodynamic cohort

2021

Self Cite

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Purpose To improve counseling in women at risk of refractory and/or de novo urgency urinary incontinence (UUI) following sling placement at time of prolapse repair, we created an outcome model to characterize changes in storage dysfunction. Materials and Methods We identified 139 women who underwent urodynamics followed by sling or no sling placement at the time of prolapse repair over a 6-year period. Our primary outcome was the presence of UUI following sling placement. Data were analyzed in SAS using chi-square, Fisher's exact, Student's t-test, and Kaplan-Meier methods. Results At baseline, the sling group had significantly higher subjective (62/81 [76.5%] vs. 18/58 [31.0%]; p<0.001), objective (62/81 [76.5%] vs. 6/58 [10.3%]; p<0.001), and occult (41/81 [50.6%] vs. 6/58 [10.3%]; p<0.001) stress urinary incontinence (SUI); and rates of subjective and objective UUI were similar to the no sling group prior to surgery. After surgery (mean follow-up 859 days) there was no difference with or without sling, in the rate of SUI (subjective, objective) and further SUI treatments (bulking agent, repeat sling). Higher rates of de novo (13/81 [16.0%] vs. 6/58 [10.3%]; p=0.454) and refractory (31/81 [38.3%] vs. 14/58 [24.1%]; p=0.048) UUI were noted in the sling group following surgery. On Kaplan-Meier analysis, a greater proportion of women in the no sling group did not report UUI at longest follow-up (hazard ratio 0.63; 95% confidence interval 0.37–1.06; p=0.081). Conclusions Women should be counseled on the risk of de novo and refractory UUI following sling placement at time of prolapse repair.

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Urodynamic and urethral pressure profilometry findings in women with voiding phase dysfunction treated with surgical urethrolysis

Dobberfuhl,

Comiter,

Deb

2023

CUAJ

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Introduction: Long-term urodynamic (UDS) and urethral pressure profilometry (UPP) parameters in women with voiding phase dysfunction following an anti-incontinence (AI) procedure have been poorly characterized. We report our 10-year UDS findings in women with voiding phase dysfunction after AI procedure, who underwent urethrolysis. Methods: We identified sequential records containing urethrolysis CPT codes over a 10-year period. Records of women with preoperative UDS were reviewed for demographics, UDS tracing, and outcomes following urethrolysis. Results: Twenty-five women (mean age 60 years) had voiding phase dysfunction and underwent urethrolysis at a mean of 47 months (interquartile range [IQR] 12–61) after AI procedure. Preoperatively, six (24%) women required intermittent catheterization. Free uroflowmetry revealed a mean: maximum peak flow (Qmax) 9.6 ml/s (IQR 7.0–11.0), voided volume 137 ml (IQR 81–169), and postvoid residual 167 ml (IQR 43–288). UDS revealed a mean: UPP length 24 mm (IQR 20–27), UPP closure pressure 78 cmH2O (IQR 59–103), Pdet@Qmax 31 cmH2O (IQR 19–43), Qmax 7.9 ml/s (IQR 5.0–12.0), bladder outlet obstruction index 15 (IQR 0–34), and bladder contractility index 71 (IQR 60–81). UPP length was significantly associated (Pearson correlation, p<0.05) with: bladder outlet obstruction index (r=0.80), Pdet@Qmax (r=0.75), and time since AI procedure (r=-0.70). UPP closure pressure was significantly associated with age (r=-0.64), volume of first (r=-0.64) and strong (r=-0.78) desire, and capacity (r=-0.71). Following urethrolysis, spontaneous voiding was achieved in 23 (92%) women at followup (mean 308 days). Conclusions: UPP may help characterize outlet parameters in women with voiding phase dysfunction following an AI procedure, who ultimately undergo urethrolysis.

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The mechanical stop test and isovolumetric detrusor contractile reserve are associated with immediate spontaneous voiding after transurethral resection of prostate

Cited by 3 publications

References 19 publications

Effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction

Effect of bladder filling volume on detrusor contractility in men with bladder outlet obstruction

The evolution of incontinence into resolved, refractory and de novo urgency urinary incontinence following sling placement at time of prolapse repair in a large urodynamic cohort

Urodynamic and urethral pressure profilometry findings in women with voiding phase dysfunction treated with surgical urethrolysis

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