Usefulness of an algebraic fitting of nomograms allowing evaluation detrusor contractility in women.

AIMS

Nomograms based on Valentini-Besson-Nelson (VBN) model implying only 3 measurements (filling bladder volume, maximum flow-rate [Q] and detrusor pressure at Q) were recently developed to evaluate detrusor contractility (k) and urethral obstruction (U) in women. As their algebraic fitting leads to fast evaluations (Excel software), our aims were applications to populations of non-neurologic women without and with bladder outlet obstruction (BOO).

METHODS

The software was applied to measurements obtained during pressure flow studies. Hidden hypothesis of nomograms were no significant contribution of abdominal pressure between onset of flow and Q and standard nervous excitations until Q. Studied populations were 202 women without symptom suggestive of obstruction and 125 women with proven anatomical urethral obstruction who underwent urodynamic study.

RESULTS

For non-obstructed women, a good agreement was found between the values of k and U obtained using nomograms or a complete VBN analysis of the recorded curves. Whatever the obstructive status, there was a good correlation between the value of k and U. Evolution with ageing was similar with higher values of k and U in the BOO group. Curves k(age) and U(age) gave coefficients allowing an age adjustment. The high k value in the detrusor overactive (DO) group was consistent with a similar effect to that of BOO on the detrusor.

CONCLUSION

Evaluation of detrusor contractility (k) and urethral obstruction (U) can be obtained from the point of Q during pressure-flow study. Evolution with ageing is similar with (higher values) or without BOO. DO also induces an increased detrusor contractility.

LEVEL OF EVIDENCE