Objective: Palliative transurethral prostatectomy (TURP) is the mainstay of treatment for lower urinary tract symptoms, (LUTS) in men with prostate cancer. Functional outcomes, however, can often be unsatisfactory. Here the value of preoperative urodynamics was investigated in these men. Methods: A retrospective review was conducted of41men with prostate cancer and LUTS who were investigated by urodynamics prior to TURP. All were treated solely by primary androgen deprivation. 19 men with urodynamic proven bladder outflow obstruction (BOO) proceeded to palliative TURP. Results: Of the 41 men investigated by cystometry, the urodynamic diagnosis was BOO in 12 (29%) men, detrusor overactivity in 12 (29%) men with 7 (17%) having both diagnoses. 6 (15%) men were found to have underactive or acontractile detrusors while 4 (10%) had normal studies. In men who proceeded to TURP, all demonstrated improved flow rates (p = 0.003). At 12 months, 95% were voiding spontaneously with only 1 man requiring permanent re-catheterisation. These results compared very favourably to published outcomes which have not used urodynamics to select men for surgery. Conclusions: Urodynamics may help identify objective BOO prior to palliative TURP. Further prospective trials are justified to assess the role of urodynamics in this context.

Objectives: To investigate the association between detrusor after-contraction and urodynamic parameters in a cohort of patients undergoing urodynamic studies by ambulatory monitoring. Methods: All symptomatic adult female patients with non-neurogenic lower urinary tract dysfunction having ambulatory monitoring over the period January 1998 to January 2014 were included. Urodynamic traces were reviewed to identify detrusor aftercontraction. Measured urodynamic variables were Q max (mL/s), V void (mL) and P det.Qmax (cmH 2 O). Student's unpaired t-test was used to compare the mean of the variable in the detrusor after-contraction and non-detrusor after-contraction groups. Results: We identified 331 women with a median age of 50 years (range 16-82). Detrusor after-contraction was seen after at least one void in 122 patients giving a prevalence of 37%. A total of 167 (51%) patients had detrusor overactivity. Diagnosis of detrusor overactivity was associated with the presence of detrusor after-contraction (P < 0.05). Overall, patients with detrusor after-contraction had a statistically higher mean P det.Qmax (32 vs 28 cmH 2 O, P = 0.04) and lower mean voided volume (300 vs 378 mL, P < 0.001). Conclusion: These findings suggest a relatively high prevalence of detrusor aftercontraction during ambulatory monitoring, and an association between detrusor overactivity, V void , P det.Qmax and detrusor after-contraction recorded during ambulatory monitoring. Therefore, a link between detrusor after-contractions and the syndrome of overactive bladder can be postulated.

ARTICLE INfO ______________________________________________________________ ______________________Objectives: To determine whether there are differences in pressure and flow measurements between conventional cystometry (CONV) and ambulatory urodynamic monitoring (AMB) in women with overactive bladder syndrome and urinary incontinence. Materials and Methods:Retrospective study which included female subjects who underwent both CONV (with saline filling medium) and AMB, separated by less than 24 months, not using medication active on the lower urinary tract and without history of prior pelvic surgery. Both tests were carried out in compliance with the International Continence Society standards. The paired Student's t test was used to compare continuous variables. Bland-Altman statistics were used to assess the agreement of each variable between both studies. Results: Thirty women with a median (range) age of 50 (14 -73) years met the inclusion criteria. AMB was carried out at a mean (SD) of 11 (6) months after CONV. Measurements of p ves and p abd at the end of filling, and Q max were significantly higher from AMB recordings. There were no differences in p det at the end of filling, p detQmax or p detmax during voiding, nor significant difference in V void . Conclusions:We provide previously undocumented comparative voiding data between CONV and AMB for patients who most commonly require both investigations. Our findings show higher values of Q max but similar values of p detQmax measured by AMB which may partly reflect an overall lower catheter caliber, physiological filling but perhaps also more 'normal' voiding conditions.

adequately completed 3-day frequencyvolume chart were recruited. Each underwent two consecutive PFS with filling to MCC and average V void in a random order, and measurements of p det.Qmax and Q max were compared. For men, the agreement for a diagnosis of obstruction between the tests was also assessed. RESULTSComplete data were obtained from 76 (90%) of the patients, with a mean (range) age of 64 (20-94) years. The mean ( SD ) difference between MCC and average V void was 134 (113) mL ( P < 0.01). There were no significant differences between estimates of Q max , at -0.1 (3) mL/s ( P = 0.75), and of p det.Qmax , at -1 (13) cmH 2 O ( P = 0.91), obtained within each patient. For men there was 91% agreement (32 of 35) in the classification of obstruction. CONCLUSIONSRestriction of filling to the average V void during PFS allows a closer approximation to normal voiding and results in no clinically relevant change to the value of standard pressure-flow measurements or alters individual classification of obstruction.