Continuous urethral pressure measurements; measurement techniques; pressure variations; clinical interpretations; and clinical relevance. A Systematic Literature Analysis

Kummeling, Maxime T.M.; Elzevier, Henk W.; Groenendijk, P.M.

doi:10.1002/nau.22913

Cited by 7 publications

(8 citation statements)

References 56 publications

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“…10 In addition, studies have shown that the effects of the beta-3-agonist, mirabegron on urethral smooth muscle are the result of β3-AR agonism together with α1A/α1D-AR antagonism. 11 Electrophysiological studies in anesthetized rats have demonstrated the presence of urethral distension evoked afferents in the pelvic and pudendal nerves. 12 Interstitial cells (ICs) in the urethra have, in analogy with these in the intestine, the interstitial cells of Cajal (ICC), been proposed as specialized pacemakers that are involved in the generation of urethral tone.…”

Section: Urethra Sensory and Autonomic Dysfunctionmentioning

confidence: 99%

“…Bladder pain syndrome and OAB appear to share some common pathophysiology including increased purinergic, TRPV1, and muscarinic signalling, increased urothelial permeability, and aberrant urothelial differentiation . In addition, studies have shown that the effects of the beta‐3‐agonist, mirabegron on urethral smooth muscle are the result of β3‐AR agonism together with α1A/α1D‐AR antagonism . Electrophysiological studies in anesthetized rats have demonstrated the presence of urethral distension evoked afferents in the pelvic and pudendal nerves …”

Section: What Do We Know From Research and From Normal Physiology Andmentioning

confidence: 99%

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Do we assess urethral function adequately in LUTD and NLUTD? ICI‐RS 2015

Gajewski

Rahnama'i

Abrams

2017

Neurourology and Urodynamics

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Section: Urethra Sensory and Autonomic Dysfunctionmentioning

confidence: 99%

Section: What Do We Know From Research and From Normal Physiology Andmentioning

confidence: 99%

Do we assess urethral function adequately in LUTD and NLUTD? ICI‐RS 2015

Gajewski

Rahnama'i

Abrams

2017

Neurourology and Urodynamics

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“…This definition was abandoned shortly after because this is a rare phenomenon. In a recent review, it was concluded that studies on this subject have diversity in measurement techniques and materials . Urodynamic catheters with the variation of one to six sensors in the urethra have been used in the literature .…”

Section: Introductionmentioning

confidence: 99%

“…In a recent review, it was concluded that studies on this subject have diversity in measurement techniques and materials. 5 Urodynamic catheters with the variation of one to six sensors in the urethra have been used in the literature. [6][7][8][9] In the studies performed with multiple urethral pressure sensors, all sensors registered the UPV simultaneously, they have, however, been best recognized at the point of maximal urethral pressure.…”

Section: Introductionmentioning

confidence: 99%

Additional value of triple‐sensor urethral catheter in demonstrating urethral pressure variations during filling cystometry

Kummeling

Bovelander

Uhm

et al. 2019

Neurourology and Urodynamics

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Aims During filling cystometry, urethral pressure variations (UPV) can be observed. The clinical relevance and a clear definition of this phenomenon are still a matter of debate. For further research and definition of UPV, it is important to determine how this condition can best be demonstrated. The purpose of this study is to compare continuous urethral pressure measurements with a single urethral‐sensor catheter and a triple urethral‐sensor catheter in demonstrating UPV. Methods Seventy‐five adult female patients requiring urodynamic investigation enrolled in this prospective study. All patients underwent two series of filling and voiding cystometry. One series was performed with a dual‐air balloon sensor urodynamic catheter, the other series with a triple urethral‐sensor catheter. UPV were defined as urethral pressure drop exceeding 30 cmH2O. Results The prevalence of UPV was 37.3% (28 out of 75 patients), more common than detrusor overactivity. The triple urethral‐sensor catheter was more sensitive than the single urethral‐sensor catheter: In eight patients UPV were demonstrated with both catheters and in 18 patients only in the measurement with the triple urethral‐sensor catheter. This difference in detection was significant (P < .001). Conclusion There is an additional value in measurement with the triple urethral‐sensor catheter for demonstration of UPV during filling cystometry. Currently, continuous measurement of urethral pressure during filling cystometry and UPV is not defined within International Continence Society terminology. The single urethral‐sensor catheter is useful for a start, however, it demonstrates less than half of all UPV

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“…4 In a recent review was concluded that despite the poor methodological quality of the performed studies UPV may be regarded a -potentially pathophysiological entity of its own within cohorts of patients with OAB. 5 anticholinergics or beta-3 receptor agonists, pudendal or sacral nerve stimulation and intravesical Botulinum toxin-A (BoNT-A) therapy. 6 In the past, surgical bladder denervation has been performed as treatment modality for OAB.…”

Section: Introductionmentioning

confidence: 99%

Initial report on subtrigonal Botulinum toxin-A (BoNT-A) therapy for female patients with urethral instability - results of a pilot study

Mt¹,

Ve²,

Ji³

et al. 2018

UNOAJ

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Introduction: We present the results of a pilot study performed in 5 female patients with overactive bladder symptoms (OAB), combined with urethral instability, treated with subtrigonal Botulinum toxin-A (BoNT-A) injections. Treatment modalities for OAB have in common that they interfere in any part of efferent and afferent signaling from the bladder to the brain, the difference is in the localization and extent of interference. We hypothesized that patients with OAB symptoms and UI could benefit more from a treatment with the mode of action at the urodynamically identified problem. Methods: This is a retrospective description of the pilot study we performed. Four patients had a long history of refractory idiopathic OAB symptoms, in one patient the main complaint was painfull bladder syndrome. In all patients UI was demonstrated during filling cystometry. Treatment was started with subtrigonal injections of 10cc lidocaine 1%. If OAB symtoms improved with more than 50%, treatment continued with subtrigonal injections with BoNT-A. Results: Four out of 5 patients OAB symptoms improved more than 50% after subtrigonal BoNT-A injections. UI disappeared in one patient after treatment. In three other patients, the maximum amplitude of the urethral pressure variations decreased from more than 40cm H2O up to a maximum of 20 cm H2O. The most remarkable change was the improvement in first sensation of filling. Conclusion: Chemical denervation by subtrigonal BoNT-A injections in patients with OAB combined with UI, resulted in improvement of refractory OAB symptoms in all patients with refractory OAB as main complaint in this study.

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Continuous urethral pressure measurements; measurement techniques; pressure variations; clinical interpretations; and clinical relevance. A Systematic Literature Analysis

Cited by 7 publications

References 56 publications

Do we assess urethral function adequately in LUTD and NLUTD? ICI‐RS 2015

Do we assess urethral function adequately in LUTD and NLUTD? ICI‐RS 2015

Additional value of triple‐sensor urethral catheter in demonstrating urethral pressure variations during filling cystometry

Initial report on subtrigonal Botulinum toxin-A (BoNT-A) therapy for female patients with urethral instability - results of a pilot study

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