Non-invasive Urodynamic Study - The Uroflowmetry (original) (raw)
Related papers
Uroflowmetry: its current clinical utility for women
International Urogynecology Journal, 2008
Uroflowmetry, the simple, non-invasive measurement of urine flow over time during micturition, has a long and interesting history, clear definitions, a clear purpose in screening for voiding difficulty and, most importantly, technical accuracy. Data interpretation is currently limiting its clinical utility, despite appropriate analysis being available in long-standing existing research. The main clinically important numerical parameters are the maximum and average urine flow rates and the voided volume. Urine flow rates are strongly dependent on voided volume. Reference to established (Liverpool) nomograms will most accurately correct for this dependency. Nomograms will also optimise the validation of uroflowmetry data and the accurate assessment of its normality, compared with fixed urine flow rates and "cutoffs" for voided volume. Abnormally slow urine flow (under the 10th centile Liverpool Nomograms) is the most clinically significant abnormality. Repeat uroflowmetry, concomitant post-void residual measurement and voiding cystometry studies are appropriate options for evaluating any abnormal uroflowmetry.
Good urodynamic practices: Uroflowmetry, filling cystometry, and pressure-flow studies
Neurourology and Urodynamics, 2002
This is the ¢rst report of the International Continence Society (ICS) on the development of comprehensive guidelines for Good Urodynamic Practice for the measurement, quality control, and documentation of urodynamic investigations in both clinical and research environments. This report focuses on the most common urodynamics examinations; uro£owmetry, pressure recording during ¢lling cystometry, and combined pressure^£ow studies. The basic aspects of good urodynamic practice are discussed and a strategy for urodynamic measurement, equipment set-up and con¢guration, signal testing, plausibility controls, pattern recognition, and artifact correction are proposed. The problems of data analysis are mentioned only when they are relevant in the judgment of data quality. In general, recommendations are made for one speci¢c technique. This does not imply that this technique is the only one possible. Rather, it means that this technique is well-established, and gives good results when used with the suggested standards of good urodynamic practice.
Home uroflowmetry: Improved accuracy in outflow assessment
Neurourology and Urodynamics, 1999
To study home uroflowmetry and to compare this method to free or "traditional" uroflowmetry in the evaluation of the patient with symptomatic benign prostatic hyperplasia (BPH), and the relationship between the values of home uroflowmetry parameters and bladder outlet obstruction (BOO). Twenty-five patients (mean age, 67 years) with symptomatic BPH were examined with home uroflowmetry, free uroflowmetry, and pressure-flow measurement. The patients were assessed using the International Prostate Symptom score; digital rectal examination; routine blood chemistry, including serum prostate-specific antigen level; urinanalysis; transrectal ultrasonography; and post-void residual urine. The 24 hr were divided into "active time" (AT) and "sleep time" (ST). AT home uroflowmetry parameters were compared to ST ones. The home uroflowmetry parameters were compared to respective ones of the free uroflowmetry as well and those obtained by pressure-flow measurement. The patients were asked about their opinion of home uroflowmetry. Home uroflowmetry was found to be a simpler and more acceptable method than free uroflowmetry. The mean Q max of AT was significantly greater than the mean Q max of ST, but the mean voided volume and mean voiding time of ST were significantly larger than those of AT. There was a close relationship between the mean Q max at home and the Q max in hospital, but the voided volume and voiding time measured in hospital were significantly larger than those at home. Home uroflowmetry provided an estimation of BOO for 46% of the patients as low if the home mean Q max was >14 ml/sec, and as high if the home mean Q max was <10 ml/sec. Home uroflowmetry was well accepted by the patients and gave more information than free uroflowmetry. In 46% of the cases, an estimation of BOO was obtained with home uroflowmetry.
Noninvasive Urodynamic Evaluation
International Neurourology Journal, 2012
The longevity of the world' s population is increasing, and among male patients, complaints of lower urinary tract symptoms (LUTS) are growing. Testing to diagnose LUTS and to differentiate between the various causes should be quick, easy, cheap, specific, not too bothersome for the patient, and noninvasive or minimally so. Urodynamic evaluation is the gold standard for diagnosing bladder outlet obstruction (BOO) but presents some inconveniences such as embarrassment, pain, and dysuria; furthermore, 19% of cases experience urinary retention, macroscopic hematuria, or urinary tract infection. A greater number of resources in the diagnostic armamentarium could increase the opportunity for selecting less invasive tests. A number of groups have risen to this challenge and have formulated and developed ideas and technologies to improve noninvasive methods to diagnosis BOO. These techniques start with flowmetry, an increase in the interest of ultrasound, and finally the performance of urodynamic evaluation without a urethral catheter. Flowmetry is not sufficient for confirming a diagnosis of BOO. Ultrasound of the prostate and the bladder can help to assess BOO noninvasively in all men and can be useful for evaluating the value of BOO at assessment and during treatment of benign prostatic hyperplasia patients in the future. The great advantages of noninvasive urodynamics are as follows: minimal discomfort, minimal risk of urinary tract infection, and low cost. This method can be repeated many times, permitting the evaluation of obstruction during clinical treatment. A urethral connector should be used to diagnose BOO, in evaluation for surgery, and in screening for treatment. In the future, noninvasive urodynamics can be used to identify patients with BOO to initiate early medical treatment and evaluate the results. This approach permits the possibility of performing surgery before detrusor damage occurs.
Uroflowmetry in female voiding disturbances
Neurourology and Urodynamics, 2003
AimsThe clinical validity of uroflowmetry in women is attenuated by lack of absolute normal values. A peak flow <15 mL/sec and/or residual urine >50 mL with a minimum total bladder volume of 150 mL before voiding (volume voided+residual) (method A) and the 10th centile curve of the Liverpool Nomogram (method B) for the maximum urine flow rate have been identified as useful discriminants when diagnosing voiding difficulties in women. This study compares the two methods and analyses the validity of uroflowmetry in female voiding disturbances.The clinical validity of uroflowmetry in women is attenuated by lack of absolute normal values. A peak flow <15 mL/sec and/or residual urine >50 mL with a minimum total bladder volume of 150 mL before voiding (volume voided+residual) (method A) and the 10th centile curve of the Liverpool Nomogram (method B) for the maximum urine flow rate have been identified as useful discriminants when diagnosing voiding difficulties in women. This study compares the two methods and analyses the validity of uroflowmetry in female voiding disturbances.MethodsA total of 348 women underwent a full urogynaecologic work-up. Evaluable results of uroflowmetry (229 with method A and 224 with method B) were analysed and compared in terms of the following clinical variables: age, parity, previous urogynaecologic surgery, prolapse grade, symptoms, postvoid residue, and incontinence. Uroflowmetry results were compared with pressure/flow study results as indicated by four different cut-offs.A total of 348 women underwent a full urogynaecologic work-up. Evaluable results of uroflowmetry (229 with method A and 224 with method B) were analysed and compared in terms of the following clinical variables: age, parity, previous urogynaecologic surgery, prolapse grade, symptoms, postvoid residue, and incontinence. Uroflowmetry results were compared with pressure/flow study results as indicated by four different cut-offs.ResultsThe odds ratio that a subject with voiding difficulty has abnormal flow is 3.7 (95% CI, 1.9–7) in the patients analysed with method A and 2.8 (95% CI, 1.6–5.2) with method B. A good accordance emerged between the two methods in flowmetry results. Uroflowmetry has a specificity of >70% and a sensitivity of 50 to 100% depending on the cut-offs. Uroflowmetry results in women can be analysed by using either of the methods.The odds ratio that a subject with voiding difficulty has abnormal flow is 3.7 (95% CI, 1.9–7) in the patients analysed with method A and 2.8 (95% CI, 1.6–5.2) with method B. A good accordance emerged between the two methods in flowmetry results. Uroflowmetry has a specificity of >70% and a sensitivity of 50 to 100% depending on the cut-offs. Uroflowmetry results in women can be analysed by using either of the methods.ConclusionsUroflowmetry has a good specificity, a high negative predictive value, and a good diagnostic capacity such as to make it useful as the first diagnostic approach in urogynaecologic patients. Neurourol. Urodynam. 22:569–573, 2003. © 2003 Wiley-Liss, Inc.Uroflowmetry has a good specificity, a high negative predictive value, and a good diagnostic capacity such as to make it useful as the first diagnostic approach in urogynaecologic patients. Neurourol. Urodynam. 22:569–573, 2003. © 2003 Wiley-Liss, Inc.
Current Opinion in Urology
This study was conducted on 466 patients reporting for urodynamic evaluation at Urodynamic/Incontinence Clinic at A F Institute of Rehab Medicine from Feb 2003 to Dec 2006. We considered the age, gender, etiology, reason for referral, and presenting complaints whereas results were formulated according to Classification of voiding disorders by International society of Incontinence. Data was analyzed using statistical package for Social Science version 10. Results: In all (466) patients, 58% were males and 42% were females. Mean age was 46.8 years. Increased frequency (61%) and incontinence (52%) were the most common presenting complaints, 158(34%) had spinal cord injuries, 58 were cases of myelodysplasias and 128 reported with stress incontinence. Urodynamic studies showed that 152(33%) had hyperactive bladders, 110(24%) had a contractile/hypo-contractile bladders, 104(22%) had stress incontinence and 56(12%) cases had normal results. Conclusion: Urodynamics helps in diagnosis of pot...
BJUI, 1996
Objectives To compare the results obtained using a portable home-based urollowmeter with the results of traditional flowmetry performed in the outpatient department (OPD). Patients and methods Sixty-seven patients (mean age 61 years, 3 8-7 9) with lower urinary tract symptoms and/or benign prostatic enlargement used flow results obtained when voiding at home and at the OPD. The highest measured maximum flow and voided volume were obtained with the home-based uroflowmeter system. However, the mean of all con secutive home-based maximum flow and voided volume measurements were lower than those obtained by single-void uroflowmetry in the OPD, a home-based uroflowmeter comprising a datalogger Conclusions Home-based uroflowmetry provides reliable and specially designed fluid sensors incorporated into disposable beakers. The results of these measurements voiding results which are comparable with those obtained in the OPD. were compared with those from uroflowmetry in the Keywords Uroflowmetry, urodynamics, home-based OPD and with other clinical variables. uroflowmetry uro
Uroflowmetry in healthy women: A systematic review
Neurourology and Urodynamics, 2016
BackgroundAlthough uroflowmetry is a widely used diagnostic test, reference values of uroflowmetry parameters in women are lacking making it difficult to interpret the test results.AimTo quantify the range of results in uroflowmetry parameters in healthy women based on a systematic review.MethodsA search was made in the International Continence Society standardization articles, PubMed, Embase and the Cochrane Library (from inception to 27 February 2014). Studies on uroflowmetry in healthy women were included. The selected articles were examined using a critical appraisal process based on the QUADAS‐2 tool and the Critical Appraisal Skills Program.ResultsMean values of uroflowmetry parameters in healthy women (mean age 37.1 years) were: voided volume (VV) 338 ml (SD 161), maximum flow rate (Qmax) 23.5 ml/s (SD 10), average flow rate (Qave) 13 ml/s (SD 6), postvoid residual (PVR) 15.5 ml (SD 25), voiding time (VT) 29 sec (SD 17), and time to maximum flow rate (time to Qmax) 8 sec (SD ...