Excretory Cystometry: A More Physiologic Method

Comarr, A. Estin

doi:10.1016/s0022-5347(17)66609-6

Cited by 24 publications

(13 citation statements)

References 4 publications

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“…In the study reported here, rapid filling of the bladder was found to cause a shift to the left of the threshold of the reflex contraction. This is in agreement with the observations reported by Comarr (1957Comarr ( , 1958) viz. that slow excretory filling of the bladder results in a higher threshold of the reflex contraction than does conventional cystometry.…”

Section: Discussionsupporting

confidence: 94%

Double Cystometry in the Uninhibited Neurogenic Bladder

Grynderup¹

2009

Acta Neurologica Scandinavica

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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.

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Section: Discussionsupporting

confidence: 94%

Double Cystometry in the Uninhibited Neurogenic Bladder

Grynderup¹

2009

Acta Neurologica Scandinavica

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“…Previous work lends support to these findings. For example, the use of natural filling cystography was reported by Comarr in 1957. He observed in paraplegic patients who mainly had suprasacral lesions that bladder capacities were greater during natural filling.…”

Section: Discussionmentioning

confidence: 99%

Ambulatory Monitoring of Bladder Pressures in Patients with Low Compliance as a Result of Neurogenic Bladder Dysfunction

Webb

Styles

Griffiths

et al. 1989

British Journal of Urology

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A group of 28 patients with neurogenic bladder dysfunction and low bladder compliance was studied using medium fill cystometry (CMG) and ambulatory monitoring (AM) during natural bladder filling. The aims of the study were to compare the 2 techniques and to determine if ambulatory monitoring might be useful in predicting upper tract dilatation. AM demonstrated significantly lower end filling pressures compared with CMG. Phasic detrusor contractions were found more commonly during AM and the frequency of phasic detrusor contractions during AM was associated significantly with poor compliance identified during CMG. Patients with upper tract dilatation had significantly greater residual urine volumes, higher pressure rises during CMG and higher frequencies of phasic detrusor contractions compared with those patients with normal upper tracts. The high pressures seen at the end of a medium fill CMG were not found during AM and therefore are unlikely to be the underlying explanation of upper tract dilatation in such patients.

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“…The first to establish ambulatory-UDS was Comarr [11]. Since its development and a more widely use of ambulatory-UDS in the 1990s [12], a reasonable number of studies have been performed to assess the applicability of ambulatory-UDS in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

The Value of Ambulatory Urodynamics in the Evaluation of Treatment Effect of Sacral Neuromodulation

et al. 2019

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Objectives: To assess the improvement of symptoms by sacral neuromodulation (SNM) in an objective way by carrying out an ambulatory urodynamic study (ambulatory-UDS). Until now, successful treatment has been defined as a ≥50% improvement recorded on voiding diaries. Voiding diaries are a patient reported outcome tool. A tool with less bias is desired to evaluate the treatment results before an expensive permanent system is implanted. Methods: Between 2002 and 2015, a total of 334 patients with lower urinary tract symptoms were included consecutively in an ambulatory-UDS database. From this database, a subgroup of patients was selected which underwent SNM. Results: In 51 patients, an ambulatory-UDS was performed both at baseline and during the SNM test period. A positive treatment outcome after test stimulation based on the patients’ voiding diary, correlated (p < 0.0001) with an improvement on ambulatory-UDS. Twenty-six of the 30 patients, who have showed improvement of more than 50% on voiding diary parameters and who had subjective improvement of their symptoms, showed an early improvement on ambulatory-UDS. Conclusions: Ambulatory-UDS can be used in clinical decision making, as it is associated with voiding diary improvement during the SNM test period. Using ambulatory-UDS to confirm success could in the future justify the shortening of the test period.

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Excretory Cystometry: A More Physiologic Method

Cited by 24 publications

References 4 publications

Double Cystometry in the Uninhibited Neurogenic Bladder

Double Cystometry in the Uninhibited Neurogenic Bladder

Ambulatory Monitoring of Bladder Pressures in Patients with Low Compliance as a Result of Neurogenic Bladder Dysfunction

The Value of Ambulatory Urodynamics in the Evaluation of Treatment Effect of Sacral Neuromodulation

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