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Noninvasive assessment of bladder contractility in men

Lookup NU author(s): Stuart McIntosh, Dr Michael DrinnanORCiD, Dr Clive Griffiths, Peter Ramsden, Rob Pickard


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Purpose: Preoperative assessment of detrusor function by pressure flow study (PFS) improves outcome from prostatectomy but is invasive and uncomfortable for the patient. We report on a large scale validation of a novel noninvasive assessment of detrusor contractility. Materials and Methods: A flexible cuff placed around the penis was inflated automatically during voiding until flow interruption. Cuff pressure at interruption (pves.isv), reflects isovolumetric bladder pressure (pves.isv), a measure of detrusor contractility. For comparison 151 symptomatic men performed the cuff test with simultaneous PFS monitoring. Test/retest agreement was assessed in 91 subjects who performed a cuff test without PFS on 2 occasions. Results: For the 117 (77%) subjects with an acceptable cuff pressure flow trace, Bland Altman analysis showed that overestimated pves.isv by a mean (s.d.) of 16.4 (27.5) cm H2O, predominantly due to the cuff being positioned below the bladder. For test/retest analysis 52 (57%) of the men who were able to attend twice provided acceptable cuff data on both occasions with a mean (s.d.) difference in of -3.3 (32.0) cm H 2O, improving to 0.0 (20.3) cm H2O in a subgroup of 39 subjects who voided more than 150 ml. On questionnaire assessment 121 (80%) subjects preferred the cuff test to PFS. Conclusions: The cuff test gives a valid and reproducible estimate of isovolumetric bladder pressure in a manner acceptable to patients, although test failure and variability of agreement require improvement. The test may be of value in the assessment of urinary symptoms and may aid in patient selection for prostatectomy.

Publication metadata

Author(s): McIntosh SL, Drinnan MJ, Griffiths CJ, Robson WA, Ramsden PD, Pickard RS

Publication type: Article

Publication status: Published

Journal: Journal of Urology

Year: 2004

Volume: 172

Issue: 4 I

Pages: 1394-1398

Print publication date: 01/10/2004

ISSN (print): 00225347

ISSN (electronic):

DOI: 10.1097/01.ju.0000139470.58006.dd

PubMed id: 15371853


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