Document Detail


The role of invasive and non-invasive urodynamics in male voiding lower urinary tract symptoms.
MedLine Citation:
PMID:  19916009     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Troublesome voiding lower urinary tract symptoms (LUTS) are a common problem in men, particularly with ageing. Implicitly, management of voiding LUTS can be guided by accurate determination of underlying mechanisms, distinguishing men with voiding symptoms caused by outlet obstruction from those with reduced bladder contractility.
METHODS: A PubMed search of the published literature on invasive and non-invasive methods used to assess lower urinary tract function was carried out.
RESULTS: A multitude of methods have been applied to assess LUTS. Multichannel pressure flow studies (PFS) are the standard for diagnosing bladder outlet obstruction and underlying mechanisms of LUTS, though their invasive nature can be difficult to tolerate, and improved prediction of treatment outcome is disputed. Uroflowmetry and post void residual measurement are insufficient to make a definitive diagnosis. Ultrasound-derived measurements of bladder wall thickness and estimated bladder weight offer a potential non-invasive alternative to PFS, but their diagnostic parameters are still under evaluation. Non-invasive methods that measure isovolumetric bladder pressure by interrupting the urinary stream can reproducibly measure pressure and urinary flow, but are unable to determine the effects of abdominal straining during voiding and give no insight into urine storage symptoms. Doppler ultrasound during urethral flow is informative, but it is an expensive approach whose clinical utility has yet to be established.
CONCLUSION: A variety of non-invasive urodynamic and non-urodynamic techniques have been used to evaluate LUTS and some show great promise. However, there is as yet, insufficient evidence to justify replacement of invasive voiding cystometry by these investigational approaches.
Authors:
Brian A Parsons; Elizabeth Bright; Ahmed M Shaban; Anne Whitehouse; Marcus J Drake
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-11-15
Journal Detail:
Title:  World journal of urology     Volume:  29     ISSN:  1433-8726     ISO Abbreviation:  World J Urol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-24     Completed Date:  2011-07-26     Revised Date:  2012-05-18    
Medline Journal Info:
Nlm Unique ID:  8307716     Medline TA:  World J Urol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  191-7     Citation Subset:  IM    
Affiliation:
Southmead Hospital, Bristol Urological Institute, Bristol, UK. brianaparsons@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Humans
Male
Prostatism / physiopathology*,  ultrasonography
Reproducibility of Results
Rheology
Ultrasonography
Urinary Bladder Neck Obstruction / physiopathology,  ultrasonography
Urination Disorders / physiopathology,  ultrasonography
Urodynamics / physiology*
Comments/Corrections
Comment In:
J Urol. 2012 May;187(5):1750   [PMID:  22494732 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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