Towards a noninvasive urodynamic diagnosis of infravesical obstruction

Mastrigt, Van

doi:10.1046/j.1464-410x.1999.00161.x

Cited by 37 publications

(20 citation statements)

References 22 publications

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“…Previous studies showed that for diagnosing BOO, one of the most frequent voiding disorders, the maximum £ow rate and the isovolumetric bladder pressure can also be used [van Mastrigt and Kranse, 1995;Comiter et al, 1996]. In the current study, we developed a classi¢cation strategy to assess BOO in male patients based on a non-invasively measured isovolumetric bladder pressure combined with a £ow rate measurement.…”

Section: Discussionmentioning

confidence: 99%

Development of a non‐invasive strategy to classify bladder outlet obstruction in male patients with LUTS

Pel

Bosch

Blom

et al. 2002

Neurourology and Urodynamics

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To diagnose bladder outlet obstruction in male patients with lower urinary tract symptoms (LUTS), it is necessary to measure the bladder pressure via a transurethral (or suprapubic) catheter. This procedure incurs some risk of urinary tract infection and urethral trauma and is sometimes painful to the patient. We developed an external condom catheter to measure non-invasively the bladder pressure and developed a strategy to classify bladder outlet obstruction (BOO) based on this measurement. Seventy-five patients with a wide range of urological diagnoses underwent a pressure-flow study followed by a non-invasive study. We tested five different strategies to classify the patients using the provisional International Continence Society (ICS) method for definition of obstruction as the gold standard. Leakage of the external catheter occurred in eight (40%) of the first 20 tested patients. In the remaining 55 patients, only five (9%) of the measurements failed because of leakage. Of the 75 patients, 56 were successfully tested non-invasively. According to the ICS nomogram, the PFS showed that 22 of these patients were non-obstructed, 12 patients were equivocal, and 22 patients were obstructed. Ten of these 56 patients strained, and we found that the relatively high abdominal pressures in these patients were not reflected in the externally measured bladder pressure. Of the remaining 46 patients, 12 of 13 non-obstructed patients and 30 of 33 combined equivocal and obstructed patients could be correctly classified. We developed a simple, non-invasive classification strategy to identify BOO in those male patients who did not strain during voiding.

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Section: Discussionmentioning

confidence: 99%

Development of a non‐invasive strategy to classify bladder outlet obstruction in male patients with LUTS

Pel

Bosch

Blom

et al. 2002

Neurourology and Urodynamics

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“…This cuff gradually inflates and deflates, obstructing flow, several times until the patient's bladder is empty. The pressure at which flow ceases, known as the cuff pressure, is the urethral closing pressure which is a surrogate for intra-vesical pressure -the measurement usually obtained from formal invasive urodynamic testing [14][15][16]. This cuff pressure can then be read off a nomogram, validated for use with this device, and the patient categorised as obstructed or not obstructed.…”

Section: Introductionmentioning

confidence: 99%

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

2013

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Objective To assess whether the penile cuff non‐invasive urodynamic test serves as an effective diagnostic tool for predicting outcomes prior to disobstructive surgery for men presenting with voiding lower urinary tract symptoms. Patients with proven urodynamic obstruction do better after surgery. The current gold standard, invasive pressure‐flow studies, imposes cost, resource demand, discomfort and inconvenience to patients. Patients and Methods Patients undergoing surgery for prostatic obstruction at Palmerston North Hospital had pre‐operative non‐invasive urodynamics and completed an International Prostate Symptom Score (IPSS). Catheterised patients were excluded. Two months post‐operatively they completed a further IPSS score. An improvement of seven or greater was defined as a clinically successful outcome. Results were compared with the outcome predicted by the nomogram supplied with the urodynamic device. Results Data was obtained for 62 patients with mean age 70 years (range 49 to 86 years; SD 9 years). Follow‐up was complete for all patients. Thirty‐eight patients underwent transurethral resection and 24 holmium laser enucleation of the prostate. Mean IPSS score was 21 (range 5 to 35; SD 6) pre‐operatively and 11 (range 1 to 31; SD 9) post‐operatively. Thirty‐five patients were predicted obstructed and 27 not obstructed. 94% of those predicted obstructed had a successful outcome (p < 0.01). 70% predicted as not obstructed did not have a successful outcome after surgery (p < 0.01). Conclusion The penile cuff test is an exciting adjunct in the decision to proceed to surgery for prostatic obstruction. Patients predicted to be obstructed have an excellent likelihood of a good surgical outcome, yet 30% of those shown not to be obstructed will still do well. Whilst numbers in our study are small, outcomes compare favourably with published results on invasive urodynamic methods.

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“…The Prostatic volume and QOL index do not correlate well with IVPP. 18 2. IVPP has a very good positive and negative predictive value and also a good accuracy rate in comparison with all other parameters in predicting the BOO.…”

Section: Resultsmentioning

confidence: 99%

Effect of Intravesical Prostatic Protrusion (Ivpp) on Lower Urinary Tract Function and Management

T¹,

Balaji²,

Vetrichandar³

et al. 2016

jemds

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AIMS AND OBJECTIVESTo correlate Intravesical Prostatic Protrusion (IVPP) with International Prostate Symptoms Score (IPSS), Quality of Life Index (QOL), Uroflowmetry, Post Void Urine (PVR) and Pressure Flow Study (PFS) and to assess whether the presence and increasing grades of Intravesical prostatic protrusion are directly correlated with the severity of Bladder outlet obstruction due to Benign prostatic hypertrophy. MATERIALS AND METHODSNon-randomized prospective cohort study, conducted in Department of Urology, Govt. Stanley Hospital, from June 2012 to June 2015, on a sample of 100 patients with IVPP. IVPP was correlated with IPSS, Quality of life index, Uroflowmetry, Effects of drug therapy, Response to surgical therapy. Response of patients with Intravesical prostatic protrusion of same grade to surgical therapy and drug therapy are compared to decide which modality of management is best. RESULTSThe incidence of IVPP in patients presenting with LUTS due to BPH is 1 in 5. Majority present with grade 2 IVPP. The increasing grades of IVPP are significantly directly correlated with IPSS score, Q-max and Post void residual. Statistical analysis showed IVPP to correlate significantly with BOO. TURP showed a very good and significant mean decrease of IPSS and Q-max, whereas those who had medical treatment showed only a mean decrease of 2 in IPSS score and 1 in Q-max. CONCLUSIONThe increasing grades of IVPP are significantly directly correlated with IPSS score max and Post void residual. IVPP have a very good positive and negative predictive value and also a good accuracy rate in comparison with all other parameters in predicting the BOO. The surgical intervention statistically proved to be superior to medical treatment in IVPP patients. KEYWORDSIVPP, Prostate, Urology. HOW TO CITE THIS ARTICLE:Rajaraman T, Balaji AR, Vetrichandar S, et al. Effect of intravesical prostatic protrusion (IVPP) on lower urinary tract function and management.

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Towards a noninvasive urodynamic diagnosis of infravesical obstruction

Cited by 37 publications

References 22 publications

Development of a non‐invasive strategy to classify bladder outlet obstruction in male patients with LUTS

Development of a non‐invasive strategy to classify bladder outlet obstruction in male patients with LUTS

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

Effect of Intravesical Prostatic Protrusion (Ivpp) on Lower Urinary Tract Function and Management

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