A Nomogram to Characterize the Severity of Detrusor Overactivity during the Ice Water Test: Description of the Method and Proof of Concept

Reitz, André; Hüsch, Tanja; Haferkamp, Axel

doi:10.1159/000485901

Cited by 2 publications

(2 citation statements)

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“…This study we transferred a previously developed quantitative analysis of the detrusor pressure‐time‐relationship during the IWT from a population with Parkinson's disease to men with BOO . First, we are able to confirm a high rate of positive IWT (56%) in males with BOO.…”

Section: Discussionmentioning

confidence: 80%

“…In a former study in 55 patients with Parkinson's disease, we studied in the relationship of detrusor pressure and time during the IWT and developed subsequently a nomogram with 10 severity categories of detrusor overactivity (DO). The nomogram category correlated with the number of incontinence episodes, demonstrated reproducibility in repeated tests, and effects of therapeutic interventions to treat DO . Later, the concept was further validated in a larger population of 201 patients with multiple sclerosis and lower urinary tract dysfunction .…”

Section: Introductionmentioning

confidence: 95%

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Persistent storage symptoms after TURP can be predicted with a nomogram derived from the ice water test

Reitz

Hüsch

Haferkamp

2019

Neurourology and Urodynamics

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Purpose: To predict the persistence of storage symptoms after transurethral resection of the prostate (TURP) using a nomogram derived from the ice water test (IWT). Methods: The IWTs of 73 men with lower urinary tract symptoms and prostatic bladder outlet obstruction were retrospectively analyzed. The strength of the detrusor contraction was approximated by using the detrusor gradient of Δp det / Δt at maximum detrusor pressure and the area under the curve. The parameters were utilized in a nomogram, which facilitated a severity categorization from 1 to 10. Patients with a positive IWT in the categories 1 to 2 were assigned to group A, categories 3 to 4 to group B and categories 5 and higher to group C. After TURP, patients with persisting storage symptoms were offered a botulinum toxin injection. Results: There were 32 patients (44%) with negative and 41 patients (56%) with positive IWTs. Patients with negative IWTs were classified in category 1.Regarding patients with positive IWTs, 14 (34%) were correlated to group A, 14 (34%) to group B, and 13 (32%) to group C. The necessity of a subsequent botulinum toxin injection correlated significantly with a higher nomogram category (P < .001) as well as higher severity categorization (P < .001). In multivariate analysis, the nomogram category was an independent predictor for botulinum toxin injection (P = .002, OR, 6.9, CI, 2.0-23.9). Conclusion: The quantification of the detrusor contraction during the IWT allowed stratification of patients in risk categories for persistent storage symptoms after TURP and the potential need for later botulinum toxin injections. K E Y W O R D S benign prostatic outlet obstruction, detrusor overactivity, lower urinary tract symptoms, transurethral resection of the prostate, urge incontinence, urodynamics

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 95%