Simplified cystometry Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):311-316
DOI 10.1590/S0100-72032004000400008
OBJECTIVE: to assess the concordance of different urodynamic parameters with simplified cystometry, thus improving the cost-benefit relationship for stress urinary incontinence (SUI) diagnosis in woman. METHODS: we evaluated retrospectively the medical records of thirty patients treated, from January 2000 to March 2001. All patients had been submitted to physical and gynecological examinations. A conventional urodynamic study had been made using a Dynograph R-611 recorder. Simplified cystometry had used a saline tube with "Y" connector, connected to a Foley 14 Fr catheter, which allowed measurement of intra-vesical pressure at the same time as physiological saline infusion. The following parameters were analyzed: residual volume, bladder capacity, complacency, involuntary detrusor contractions, and abdominal leak-point pressure. The Pearson test of agreement and the Wilcoxon signed rank test were used to verify the concordance between related samples, with p < 0,05. RESULTS: the average age was 50 years old (28-70). Concordance between studies for stress urinary losses was 67%, and for detrusor involuntary contractions, 90%. The average residual volume was significantly different: by simplified cystometry it was 16.8 ml versus 2 ml by conventional urodynamics (p < 0.01). The average maximum vesical capacity by urodynamic study was 440.5 ml, and by simplified cystometry, 387 ml (p < 0.05). Vesical complacency was on average, significantly larger in simplified cystometry (43.0 ml/cmH2O) than in the urodynamic study (31.5 ml/cmH2O), with p < 0.01. CONCLUSION: preliminary evaluations suggest that the urogynecologic propedeutic associated with cystometry is an option to be considered in the clinical and preoperative assessment of patients with SUI instead of conventional urodynamics, particularly when the latter is not available. Simplified cystometry is an accessible exam that grants comparable results for the detection of involuntary detrusor contractions and for the identification of urinary loss, providing the examiner with trustworthy data on vesical behavior.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):311-316
DOI 10.1590/S0100-72032004000400008
OBJECTIVE: to assess the concordance of different urodynamic parameters with simplified cystometry, thus improving the cost-benefit relationship for stress urinary incontinence (SUI) diagnosis in woman. METHODS: we evaluated retrospectively the medical records of thirty patients treated, from January 2000 to March 2001. All patients had been submitted to physical and gynecological examinations. A conventional urodynamic study had been made using a Dynograph R-611 recorder. Simplified cystometry had used a saline tube with "Y" connector, connected to a Foley 14 Fr catheter, which allowed measurement of intra-vesical pressure at the same time as physiological saline infusion. The following parameters were analyzed: residual volume, bladder capacity, complacency, involuntary detrusor contractions, and abdominal leak-point pressure. The Pearson test of agreement and the Wilcoxon signed rank test were used to verify the concordance between related samples, with p < 0,05. RESULTS: the average age was 50 years old (28-70). Concordance between studies for stress urinary losses was 67%, and for detrusor involuntary contractions, 90%. The average residual volume was significantly different: by simplified cystometry it was 16.8 ml versus 2 ml by conventional urodynamics (p < 0.01). The average maximum vesical capacity by urodynamic study was 440.5 ml, and by simplified cystometry, 387 ml (p < 0.05). Vesical complacency was on average, significantly larger in simplified cystometry (43.0 ml/cmH2O) than in the urodynamic study (31.5 ml/cmH2O), with p < 0.01. CONCLUSION: preliminary evaluations suggest that the urogynecologic propedeutic associated with cystometry is an option to be considered in the clinical and preoperative assessment of patients with SUI instead of conventional urodynamics, particularly when the latter is not available. Simplified cystometry is an accessible exam that grants comparable results for the detection of involuntary detrusor contractions and for the identification of urinary loss, providing the examiner with trustworthy data on vesical behavior.