Qin Y, Wang F, Zhang J Z, Wu L Y, Zhang C H, Hu X P, Zhang P
Department of Urology, Beijing Chao-yang Hospital, Capital Medical University, Beijing 100020, China.
Zhonghua Yi Xue Za Zhi. 2022 Dec 13;102(46):3693-3697. doi: 10.3760/cma.j.cn112137-20220318-00569.
To evaluate the measurements of urethral pressure profile (UPP) using air-charged catheters (ACC) in women with bladder neck obstruction and to preliminarily analyze the diagnostic value of UPP based on ACC for female bladder neck obstruction. Retrospective inclusion of 63 female patients with bladder neck obstruction diagnosed in the Department of Urology of Beijing Chao-yang Hospital from September 2020 to December 2021 were included as the observation group, and 45 female patients who came to the hospital due to lower urinary tract symptoms with non-bladder neck obstruction during the same period were selected as the control group. All patients received urodynamic examination and UPP examination based on ACC, and urethral pressure measurements [ (, )] were compared between the two groups and analyzed the predictive value of the relevant measurements for female bladder neck obstruction. The age of the observation group was 61 (47, 67) years and body mass index (BMI) was 24.1 (21.6, 27.9) kg/m, the age of the control group was 65 (58, 71) years and BMI was 25.0 (22.8, 27.6) kg/m. The urethral pressure at the bladder neck and urinary sphincter position in the observation group were higher than control group[104.00 (83.00, 124.00) cmHO (1 cmHO=0.098 kPa) vs 42.00 (31.00, 65.50) cmHO, 125.0 (107.0, 154.0) cmHO vs 99.0 (77.0, 124.0) cmHO, <0.001]. The results of the receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of urethral pressure at the bladder neck position had the highest predictive value for female bladder neck obstruction (AUC: 0.946, 95%: 0.886-0.981, sensitivity: 87.3%, specificity: 91.1%), and the results of interaction point plot showed that the cut-off value was 72 cmHO. The cut-off value of urethral pressure at the bladder neck position was used as positive cut-off value to predict female patients with bladder neck obstruction. Sixty-three patients with bladder neck obstruction were detected by UPP measurement using ACC in 59 cases (59/63, 93.7%) and the Kappa value was 0.774 (95%: 0.654-0.894), indicating that UPP had high consistency with pressure-flow study. UPP examination based on ACC can show the pressure values of the bladder neck and urethral sphincter position. When the urethral pressure of the bladder neck position is greater than 72 cmHO, it is helpful for the diagnosis of female bladder neck obstruction and has guiding significance for the diagnosis and treatment of this disease.