Double Cystometry in the Uninhibited Neurogenic Bladder

Abstract

Various methods have been employed in cystometry. I t has been done by isotonic and isometric measurements, and measurements of both the pressure and the filling of the bladder have been used, either continuously or discontinuously.I n several Danish hospitals, modifications of the method devised by Povlsen (1942) are used. By this method, the intravesical pressure is transmitted through a catheter inserted per urethram, via a pressure chamber, to a manometer. Modifications of this method have previously been used in studies on neurogenic bladder dysfunction (Juul-Jensen and Ejner Pedersen 1959, Ejner Pedersen and Juul-Jensen 1962, 1965.In cystometry of the uninhibited neurogenic bladder it is very important to distinguish between bladder tonus and reflex contraction (Tang and Ruch 1955). Much confusion and discussion could have been avoided if this had been done consistently. One way of solving this problem is to record the reflex contractions isometrically. I n this paper, a description is given of a modification of the method of Povlsen in which the reflex contractions are allowed to pass off and are recorded isometrically.A procedure which is often used in the evaluation of a certain method of examination is to make duplicate determinations. By such determinations, it is also sometimes possible to decide if the examination as such exerts any influence on the phenomenon studied.Double cystometry was used by Rose (1936) in the normal and irritable human bladder and in the low-sensation type of neurogenic bladder. This method was also used by Povlsen (1941) in patients with hypertrophy of the prostate. Repeated cystometry was performed by Tang and Ruch (1955) and Plum and Colfelt (1960) in cats andby Plum (1960) in the normal human bladder. However, since Rose's investigations it seems that little attention has been paid to repeated cystometry in the human neurogenic bladder.In the investigation reported here double cystometry was used to study how the reflex contraction of the uninhibited neurogenic bladder was susceptible to distension and rapid bladder filIing. At the same time, the error in the determination of the first reflex contraction was studied.

Reproducibility of same session repeated cystometry and pressure‐flow studies in women with symptoms of urinary incontinence

“…In the present study, we did not find a reduction in unstable detrusor contractions in the second fill as has previously been described. 3,8,9 The signs of urodynamic stress incontinence or detrusor overactivity were highly reproducible. Several previous studies have shown that detrusor overactivity cannot always be detected in patients, despite clear symptoms of urgency, frequency, and urge incontinence.…”

Urodynamics in patients with spinal cord injury: A clinical review and best practice paper by a working group of The International Continence Society Urodynamics Committee

“…[19][20][21] Ten to one hundred milliliter per minute cystometry appears to be as useful as registration during physiological filling to describe the maximum detrusor pressure and the mean duration of contraction in patients with a spinal NDO. 24,25 Furosemidestimulated filling cystometry (FCMG) seems to provide more reliable informations that conventional cystometry on detrusor characteristics (maximum detrusor pressure and compliance) in NDO but not in hyporeflexic or areflexic neurogenic bladder. 26 UDS should be performed in supine position on a padded table in complete SCI patients.…”

Pharmacological studies of the uninhibited neurogenic bladder

“…Rose (1936) reported that repeated cystometries increased intravesical pressure and decreased capacity in a few normal persons. Grynderup (1966) found unaltered capacity of the uninhibited neurogenic bladder at the second filling when the iilling was discontinued at the first detrusor contraction. In intact cats, Klevmark (1977) usually found less increase in intravesical pressure at the second filling to the same volume, when a high and non-physiological.…”

“…To what extent the capacity of the human bladder is dependent on the 'filling rate is a matter of controversy. Grynderup (1966) who investigated uninhibited bladders, found decreased capacity when cystometry was repeated at a filling rate higher than at the 6rst 6lling. Lungworthy et al (1936) in studies on the uninhibited bladder, Cass et al (1970) in normal bladder and Ramsden et al (1977) in both types of bladders, found that the capacity was independent of the filling rate.…”