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Virseda‐Chamorro M, Ruiz S, García G, Queissert F, Salinas J, Arance I, Angulo JC. Do voiding urodynamic parameters predict the success of adjustable transobturator male system (ATOMS) to treat postprostatectomy urinary incontinence? Neurourol Urodyn 2020; 39:1746-1752. [DOI: 10.1002/nau.24416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/24/2020] [Indexed: 01/07/2023]
Affiliation(s)
| | - Sonia Ruiz
- Department of UrologyHospital Universitario de Getafe Madrid Spain
| | - Gonzalo García
- Clinical Department, Faculty of Medical SciencesUniversidad Europea de Madrid Madrid Spain
| | - Fabian Queissert
- Department of Urology and Pediatric UrologyUniversity Hospital of Muenster Muenster Germany
| | - Jesús Salinas
- Department of UrologyHospital Clínico de San Carlos Madrid Spain
| | - Ignacio Arance
- Department of UrologyHospital Universitario de Getafe Madrid Spain
- Clinical Department, Faculty of Medical SciencesUniversidad Europea de Madrid Madrid Spain
| | - Javier C. Angulo
- Department of UrologyHospital Universitario de Getafe Madrid Spain
- Clinical Department, Faculty of Medical SciencesUniversidad Europea de Madrid Madrid Spain
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Rademakers K, Drake MJ, Gammie A, Djurhuus JC, Rosier PFWM, Abrams P, Harding C. Male bladder outlet obstruction: Time to re-evaluate the definition and reconsider our diagnostic pathway? ICI-RS 2015. Neurourol Urodyn 2017; 36:894-901. [PMID: 28444709 DOI: 10.1002/nau.23178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 11/01/2016] [Indexed: 11/09/2022]
Abstract
The diagnosis of bladder outlet obstruction (BOO) in the male is dependent on measurements of pressure and flow made during urodynamic studies. The procedure of urodynamics and the indices used to delineate BOO are well standardized largely as a result of the work of the International Continence Society. The clinical utility of the diagnosis of BOO is however, less well defined and there are several shortcomings and gaps in the currently available medical literature. Consequently the International Consultation on Incontinence Research Society (ICI-RS) held a think tank session in 2015 entitled "Male bladder outlet obstruction: Time to re-evaluate the definition and reconsider our diagnostic pathway?" This manuscript details the discussions that took place within that think tank setting out the pros and cons of the current definition of BOO and exploring alternative clinical tests (alone or in combination) which may be useful in the future investigation of male patients with lower urinary tract symptoms. The think tank panel concluded that pressure-flow studies remain the diagnostic gold-standard for BOO although there is still a lack of high quality evidence. Newer, less invasive, investigations have shown promise in terms of diagnostic accuracy for BOO but similar criticisms can be levelled against these tests. Therefore, the think tank suggests further research with regard to these alternative indicators to determine their clinical utility.
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Affiliation(s)
- Kevin Rademakers
- Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marcus J Drake
- Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
| | - Andrew Gammie
- Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
| | | | | | - Paul Abrams
- Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom
| | - Christopher Harding
- Department of Urology, Freeman Hospital, Newcastle Upon-Tyne, United Kingdom
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[S2e guideline of the German urologists: Conservative and pharmacologic treatment of benign prostatic hyperplasia]. Urologe A 2016; 55:184-94. [PMID: 26518303 DOI: 10.1007/s00120-015-3984-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This report summarizes the relevant aspects of the S2e guideline of the German Urologists for the conservative and pharmacological treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Recommendations are given regarding watchful waiting, behavioral therapy, phytotherapy and pharmacological mono- and combination therapy. The influence of the different therapeutic options on bladder outlet obstruction (BOO) is described in detail.
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Rosier PF, Schaefer W, Lose G, Goldman HB, Guralnick M, Eustice S, Dickinson T, Hashim H. International Continence Society Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourol Urodyn 2016; 36:1243-1260. [DOI: 10.1002/nau.23124] [Citation(s) in RCA: 257] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 05/13/2016] [Indexed: 01/11/2023]
Affiliation(s)
- Peter F.W.M Rosier
- Department of Urology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Werner Schaefer
- Department of Medicine (Geriatrics); University of Pittsburgh; Pittsburgh Pennsylvania
| | - Gunnar Lose
- University of Copenhagen Herlev Hospital; Herlev Denmark
| | - Howard B. Goldman
- Glickman Urologic and Kidney Institute Cleveland Clinic; Lerner College of Medicine; Cleveland Ohio
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Abrams P, Damaser MS, Niblett P, Rosier PFWM, Toozs-Hobson P, Hosker G, Kightley R, Gammie A. Air filled, including "air-charged," catheters in urodynamic studies: does the evidence justify their use? Neurourol Urodyn 2016; 36:1234-1242. [PMID: 27580083 DOI: 10.1002/nau.23108] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 08/11/2016] [Indexed: 12/20/2022]
Abstract
AIMS Air filled catheters (AFCs) have been actively marketed for the past few years and in some geographic areas are widely used. However, as the scientific basis for introduction of this technology for pressure measurement in urodynamics was not clear, a study group examined the evidence. METHODS A search of the peer reviewed literature was carried out. RESULTS Four papers were identified, of which two were laboratory experiments and two were clinical papers, in female patients, that compared the pressures recorded by AFCs and those recorded using the traditional water filled catheters (WFCs). These data show that there are differences between the pressures measured by the two types of catheters. As yet, the reasons for these differences are not clear. CONCLUSIONS There should be further systematic laboratory and clinical research before AFCs can be recommended for routine clinical use. We would recommend that a professional worldwide multidisciplinary scientific society, such as the International Continence Society, should work with manufacturers and regulatory bodies to ensure that this urodynamic method is properly scientifically evaluated, in the wider interests of patient safety.
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Affiliation(s)
- Paul Abrams
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Margot S Damaser
- Department of Biomed Engineering, Cleveland Clinic, Cleveland, Ohio.,Research Service, Louis Stokes Cleveland Veterans Administration Medical Center, Cleveland, Ohio
| | | | - Peter F W M Rosier
- University Medical Centre Utrecht, Heidelberglaan, Utrecht, The Netherlands
| | | | - Gordon Hosker
- (Retired) The Warrell Unit, St Marys Hospital, Manchester, UK
| | - Robert Kightley
- Department of Medical Physics and Biomedical Engineering, University College London Hospitals NHS Foundation Trust, London, UK
| | - Andrew Gammie
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
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Roehrborn CG, Chapple C, Oelke M, Cox D, Esler A, Viktrup L. Effects of tadalafil once daily on maximum urinary flow rate in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. J Urol 2013; 191:1045-50. [PMID: 24445278 DOI: 10.1016/j.juro.2013.10.074] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 02/06/2023]
Abstract
PURPOSE Tadalafil significantly improves lower urinary tract symptoms suggestive of benign prostatic hyperplasia. We post hoc characterized changes in the maximum urinary flow rate using integrated data from 4 international, placebo controlled studies of tadalafil once daily for lower urinary tract symptoms suggestive of benign prostatic hyperplasia. MATERIALS AND METHODS After a 4-week placebo lead-in period 1,500 men were randomized to tadalafil 5 mg or placebo for 12 weeks. Data were analyzed using ANCOVA. Maximum urinary flow rate values were rank transformed for analysis. RESULTS Baseline maximum urinary flow rate data were available on 1,371 men with a mean age of 63.1 years and end point data were available on 1,197. Tadalafil 5 mg significantly increased maximum urinary flow vs placebo (median 1.1 vs 0.4 ml per second, p = 0.003). At a baseline voided volume of 125 to less than 250 ml the median change in the maximum urinary flow rate was 0.9 and 1.2 ml per second (p = 0.142) in 731 patients, at a baseline of 250 to 450 ml the change was -0.3 and 0.7 ml per second (p = 0.011) in 428, and at a baseline of greater than 450 ml the change was -0.2 and 2.0 ml per second (p = 0.186) in 38 for placebo and tadalafil, respectively. The difference was 0.3, 1.0 and 2.2 ml per second, respectively. At a baseline maximum urinary flow rate of greater than 15 ml per second in 128 patients the median flow rate change was -2.1 and -0.8 ml per second (p = 0.246), at a maximum of 10 to 15 ml per second in 522 the change was 0.2 and 0.8 ml per second (p = 0.044), and at a maximum of less than 10 ml per second in 547 the change was 1.2 and 1.8 ml per second (p = 0.189) for placebo and tadalafil, respectively. Tadalafil improved I-PSS (International Prostate Symptom Score) voiding subscores significantly vs placebo across all baseline maximum urinary flow subgroups (each p <0.001). CONCLUSIONS This integrated analysis revealed a small but statistically significant median maximum urinary flow rate improvement for tadalafil vs placebo. The numerical difference in the maximum urinary flow change from baseline between tadalafil and placebo increased with increased voided volume.
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Affiliation(s)
- Claus G Roehrborn
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Christopher Chapple
- Department of Urology, Royal Hallamshire Hospital, Sheffield Teaching Hospital National Health Service Foundation Trust, Sheffield, United Kingdom
| | - Matthias Oelke
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - David Cox
- Lilly Research Laboratories, Eli Lilly and Co., Indianapolis, Indiana
| | - Anne Esler
- inVentiv Health Clinical, Indianapolis, Indiana
| | - Lars Viktrup
- Lilly Research Laboratories, Eli Lilly and Co., Indianapolis, Indiana
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Utomo E, Groen J, Vroom IH, van Mastrigt R, Blok BF. Urodynamic Effects of Volume-adjustable Balloons for Treatment of Postprostatectomy Urinary Incontinence. Urology 2013; 81:1308-14. [DOI: 10.1016/j.urology.2013.01.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 01/11/2013] [Accepted: 01/14/2013] [Indexed: 11/29/2022]
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Kraus SR, Dmochowski R, Albo ME, Xu L, Klise SR, Roehrborn CG. Urodynamic standardization in a large-scale, multicenter clinical trial examining the effects of daily tadalafil in men with lower urinary tract symptoms with or without benign prostatic obstruction. Neurourol Urodyn 2010; 29:741-7. [DOI: 10.1002/nau.20825] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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YAMANISHI T, MASUDA A, MIZUNO T, KAMAI T, TATSUMIYA K, FUKUDA T, FURUYA N, WATANABE M, SAKAKIBARA R, UCHIYAMA T, YOSHIDA KI. Ambulatory Urodynamics in Asymptomatic, Young, Healthy Male Volunteers. Low Urin Tract Symptoms 2009. [DOI: 10.1111/j.1757-5672.2009.00003.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Clarkson B, Robson W, Griffiths C, McArdle F, Drinnan M, Pickard R. Multisite Evaluation of Noninvasive Bladder Pressure Flow Recording Using the Penile Cuff Device: Assessment of Test-Retest Agreement. J Urol 2008; 180:2515-21. [DOI: 10.1016/j.juro.2008.08.076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Indexed: 11/24/2022]
Affiliation(s)
- Becky Clarkson
- Department of Medical Physics, Newcastle University, Newcastle upon Tyne, United Kingdom
- School of Clinical and Laboratory Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Wendy Robson
- Department of Urology, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Clive Griffiths
- Department of Medical Physics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Frank McArdle
- Department of Medical Physics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Michael Drinnan
- Department of Medical Physics, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Robert Pickard
- Department of Urology, Newcastle University, Newcastle upon Tyne, United Kingdom
- Freeman Hospital and School of Surgical and Reproductive Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Meuleman EJ. Editorial comment on: The immediate and 6-mo reproducibility of pressure-flow studies in men with benign prostatic enlargement. Eur Urol 2007; 52:1193-4. [PMID: 17293024 DOI: 10.1016/j.eururo.2007.01.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Eric J Meuleman
- Free University Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
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Perrin P. Editorial comment on: The immediate and 6-mo reproducibility of pressure-flow studies in men with benign prostatic enlargement. Eur Urol 2007; 52:1194. [PMID: 17293027 DOI: 10.1016/j.eururo.2007.01.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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