Constrictive versus compressive bladder outflow obstruction in men: Does it matter?

Introduction: Bladder outflow obstruction (BOO) is a urethral resistance (UR) at a level above a clinically relevant threshold. UR is currently graded in terms of the existence and severity of the BOO based on maximum flowrate and associated detrusor pressure only. However, the pressure-flow relation throughout the course of voiding includes additional information that may be relevant to identify the type of BOO.

Quantifying bladder outflow obstruction in men: A comparison of four approximation methods exploiting large data samples.

Introduction: A pressure flow study (PFS), part of the International Continence Society standard urodynamic test, is regarded gold standard for the classification and quantification of the urethral resistance (UR), expressed in the bladder outflow obstruction (BOO). For men with benign prostatic hyperplasia, the minimum urethral opening pressure (p ), found at the end of the passive urethral resistance relation is considered the relevant parameter describing BOO. However, in clinical practice, direct measurements of p are easily confounded by terminal dribbling.

ICS-SUFU standard: Theory, terms, and recommendations for pressure-flow studies performance, analysis, and reporting. Part 2: Analysis of PFS, reporting, and diagnosis.

Aims: The Working Group (WG), initiated by the International Continence Society (ICS) Standardisation Steering Committee and supported by the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction, has revised the ICS Standard for pressure-flow studies of 1997.

Methods: Based on the ICS standard for developing evidence-based standards, the WG developed this new ICS standard in the period from May 2020 to December 2022. A draft was posted on the ICS website in December 2022 to facilitate public discussion and the comments received have been incorporated into this final release.

ICS-SUFU standard: Theory, terms, and recommendations for pressure-flow studies performance, analysis, and reporting. Part 1: Background theory and practice.

Aims: The working group (WG) initiated by the International Continence Society Standardization Steering Committee and supported by the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction has revised the (1997) ICS Standard for pressure flow studies.

Methods: Based on the ICS standard for developing evidence-based standards, the WG developed this new ICS standard in the period from May 2020 to December 2022. A draft was posted on the ICS website in January 2023 to facilitate public discussion and the comments received have been incorporated into this final release.

Acceptability and perceived value of urodynamics from the patient perspective: A narrative review.

Background: The value and application of urodynamic evaluation (UDS) have been a controversial topic in recent years. Gaining robust data on the patient viewpoint in this area is important since, even when UDS findings do not change the management plan, the objective diagnostic information gained from UDS may be valued by patients. Moreover, insights from UDS may empower treating physicians to counsel patients more effectively and manage their expectations regarding treatment outcomes.

Head-to-head comparison of pressures during full cystometry, with clinical as well as in-depth signal-analysis, of air-filled catheters versus the ICS-standard water-filled catheters.

Aims: To compare in vivo differences of two catheter systems for urodynamics to further discover their measurement properties.

Methods: Side-by-side catheterization with two catheters for intravesical and abdominal pressure during full cystometry in 36 prospectively recruited patients with analysis of mean and absolute differences at urodynamic events and post hoc in-depth signal analysis comparing the full pressure traces of both systems.

Results: The mean pressure differences at urodynamic events between air-filled and water-filled systems are small, however, with a large variation, without a systematic difference.

International Urogynecology Consultation Chapter 1 Committee 5: relationship of pelvic organ prolapse to associated pelvic floor dysfunction symptoms: lower urinary tract, bowel, sexual dysfunction and abdominopelvic pain.

Introduction And Hypothesis: This article from Chapter 1 of the International Urogynecology Consultation (IUC) on Pelvic Organ Prolapse (POP) establishes the prevalence of lower urinary tract disorders, bowel symptoms, vulvo-vaginal/lower abdominal/back pain and sexual dysfunction in women with POP.

Methods: An international group of nine urogynecologists/urologists and one medical student performed a search of the literature using pre-specified search terms in Ovid, MEDLINE, Embase and CINAHL from January 2000 to March 2019. Publications were eliminated if not relevant or they did not include clear definitions of POP or the symptoms associated with POP.

Sensations Reported During Urodynamic Bladder Filling in Spinal Cord Injury Patients Give Additional Important Information.

Purpose: This study investigated the sensations reported during filling cystometry in patients with spinal cord lesions (SCLs) of different levels and completeness.

Methods: In this retrospective cohort study, information was gathered on patients' age and sex, cause of SCL, American Spinal Injury Association Impairment Scale (AIS), and lower urinary tract-related sensations in daily life. Filling cystometry (videourodynamics) was performed following the International Continence Society Good Urodynamic Practice Guidelines.

Good urodynamic practice: Pressure signal quality immediately after catheter insertion for cystometry with a water-filled pressure transducer system and its relevance for the ICS zero procedure.

Aim: This study aims to evaluate the intracorporeal pressures immediately after the insertion of the catheters for urodynamic testing with a water-filled urodynamic pressure transducer system to determine the relevance of the International Continence Society (ICS) zeroing principles.

Methods: Here, a retrospective analysis of a random series of urodynamic recordings is performed. The initial pressures, immediately after the insertion of the catheters, have been compared with the pressures after some milliliters of filling and flushing away of the gel, used with insertion, and/or the mucus and debris from the inserted catheters.

What developments are needed to achieve less-invasive urodynamics? ICI-RS 2019.

Aims: To assess the state of technologies for urodynamics that are less invasive than standard cystometry and pressure-flow studies and to suggest areas needing research to improve this.

Methods: A summary of a Think Tank debate held at the 2019 meeting of the International Consultation on Incontinence Research Society is provided, with subsequent analysis by the authors. Less-invasive techniques were summarized, classified by method, and possible developments considered.

Is the value of urodynamics undermined by poor technique?: ICI-RS 2018.

Introduction: The quality of urodynamic measurements in clinical practice has been debated as a matter of concern. It is considered plausible that this has a direct bearing on patient care and the perceived value of urodynamic testing.

Methods: This is a report of the proceedings of the Think Tank: "Is the value of urodynamics undermined by poor technique?" from the Annual International Consultation on Incontinence-Research Society, which took place in June 2018 in Bristol, UK.

Contemporary diagnosis of lower urinary tract dysfunction.

Diagnosis of lower urinary tract (LUT) dysfunction starts with categorization in clinical syndromes, and initial management is based on the assumptions about pathophysiology that these syndromes contain. However, clinical practice guidelines are ambiguous in clinical specialists' diagnosis of dysfunction after failure of initial management. This is a narrative and critical review of the existing evidence, and the aim is to suggest practice improvements in the process of clinical specialists' diagnosis for patients resistant to initial management.

Critical steps in developing professional standards for the International Continence Society.

Aims: Standardization on the basis of systematic assessment of evidence has become an indispensable element of modern healthcare. International Continence Society (ICS) has initiated and produced extremely well cited standardization documents. The process of standardization is recently depicted in a published manuscript, to keep up with modern society healthcare demands.

Basics of videourodynamics for adult patients with lower urinary tract dysfunction.

Aims: Videourodynamics is the addition of imaging to invasive urodynamics and one of the methods to ensure objective diagnosis in persons with signs or symptoms of lower urinary tract dysfunction. This manuscript has the aim to outline the basics of the practice of videourodynamics and to elementary explain interpretation of the results.

Methods: Literature sources and expert opinion were arranged to provide the reader with an introductory overview of current knowledge.

Clinical Epidemiology: Detrusor Voiding Contraction Maximum Power, Related to Ageing.

Objective: To report clinical epidemiology of detrusor (bladder) muscle contraction maximum related to ageing in patients referred with signs and symptoms of lower urinary tract dysfunction.

Study Design And Setting: One thousand three hundred and eight urodynamic pressure-flow measurements were analyzed in retrospective. Standard measures of detrusor muscle voiding contraction strength were compared for gender and ranked by age (range 20-90 years).

ICS educational module: Cystometry in children.

Aims: To introduce the standard procedure of cystometry and interpretation of the results in children.

Methods: The literature on cystometry in children in PubMed for the last 20 years was reviewed. The updated knowledge regarding indication, preparation, technique, and interpretation of cystometry in children were summarized.

What research is needed to validate new urodynamic methods? ICI-RS2017.

Aims: In recent years urodynamic innovations, although well researched, have failed to follow a standardized development pathway specifically in terms of clinical trials undertaken to demonstrate efficacy. This was discussed at the International Consultation on Incontinence Research Society (ICI-RS) in Bristol, United Kingdom, 2017 with the aim of defining minimum standards for future urodynamic research.

Methods: The recent recommendations from the IDEAL (innovation, development, exploration, assessment, and long-term study) collaboration regarding surgical research were reviewed.