The effect of bladder sensation on uroflowmetry parameters in healthy young men

Brain Responses Difference between Sexes for Strong Desire to Void: A Functional Magnetic Resonance Imaging Study in Adults Based on Graph Theory

Background: The alternations of brain responses to a strong desire to void were unclear, and the gender differences under the strong desire to void remain controversial. The present study aims to identify the functional brain network's topologic property changes evoked by a strong desire to void in healthy male and female adults with synchronous urodynamics using a graph theory analysis. Methods: The bladders of eleven healthy males and eleven females were filled via a catheter using a specific infusion and withdrawal pattern. A resting-state functional magnetic resonance imaging (fMRI) was performed on the enrolled subjects, scanning under both the empty bladder and strong desire to void states. An automated anatomical labeling (AAL) atlas was used to identify the ninety cortical and subcortical regions. Pearson's correlation calculations were performed to establish a brain connection matrix. A paired t-test (p < 0.05) and Bonferroni correction were applied to identify the significant statistical differences in topological properties between the two states, including small-world network property parameters [gamma (γ) and lambda (λ)], characteristic path length (Lp), clustering coefficient (Cp), global efficiency (Eglob), local efficiency (Eloc), and regional nodal efficiency (Enodal). Results: The final data suggested that females and males had different brain response patterns to a strong desire to void, compared with an empty bladder state. Conclusions: More brain regions involving emotion, cognition, and social work were active in females, and males might obtain a better urinary continence via a compensatory mechanism.

Comparison of uroflowmetry tests performed with a sensation of normal desire to void versus urgency and correlation of test results with IPSS

OBJECTIVE

The objective of this study was to evaluate the uroflowmetry test results performed for normal and urgent desire to void and their correlation with International Prostate Symptom Score (IPSS) values in adult male patients having lower urinary tract symptoms (LUTS) complaints.

MATERIAL AND METHODS

In this prospective study, a total of 83 patients were included. With a normal desire to void, maximum flowrate (Qmax)-normal, average flowrate (Qaverage)-normal, and void volume (VV)-normal values were obtained. Residual urine volume was examined by suprapubic ultrasound within 5 minutes following uroflowmetry, and calculated. The maximum bladder volume (MBV)-normal value was calculated by adding the residual-normal volume and VV-normal values. The same procedures were repeated the next day with the sensation of urgency, Qmax-urgency, Qaverage-urgency, VV-urgency, residue-urgency, MBV-urgency values were obtained.

RESULTS

Statistically significant difference was determined for all parameters, and higher values were obtained in the urgency group for all parameters (p<0.05). A correlation analysis was performed for the Qmax-normal and Qmax-urgency values and the IPSS. Both parameters were not statistically significantly correlated with IPSS, but the correlation coefficient of Qmax-urgency was found to be higher than Qmax-normal (p=0.85, Correlation Coefficient=-0.022 for Qmax-normal and IPSS; and p=0.069, Correlation Coefficient=-0.214 for Qmax-urgency and IPSS, respectively).

CONCLUSION

Our study is the first study examining the effect of bladder sensitivity on uroflowmetry parameters in male patients having LUTS. More reliable results might be obtained in adult male patients with LUTS complaints when the uroflowmetry test is performed with a feeling of urgency to void. Our results need to be supported by more objective criteria, rather than subjective criteria such as IPSS.

How can we maximize the diagnostic utility of uroflow?: ICI-RS 2017

AIMS

To gauge the current level of diagnostic utility of uroflowmetry and to suggest areas needing research to improve this.

METHODS

A summary of the debate held at the 2017 meeting of the International Consultation on Incontinence Research Society, with subsequent analysis by the authors.

RESULTS

Limited diagnostic sensitivity and specificity exist for maximum flow rates, multiple uroflow measurements, and flow-volume nomograms. There is a lack of clarity in flow rate curve shape description and uroflow time measurement.

CONCLUSIONS

There is a need for research to combine uroflowmetry with other non-invasive indicators. Better standardizations of test technique, flow-volume nomograms, uroflow shape descriptions, and time measurements are required.