Refining Diagnosis of Anatomic Female Bladder Outlet Obstruction: Comparison of Pressure-Flow Study Parameters in Clinically Obstructed Women With Those of Normal Controls

Defreitas, Gina A.; Zimmern, P.; Lemack, Gary E.; Shariat, S.F.

doi:10.1016/s0022-5347(06)00210-2

Cited by 142 publications

(77 citation statements)

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“…Außerdem werden häu-fig unspezifische urethrale Beschwerden wie Dysurie, Algurie, rezidivierende Urethritiden sowie irritative Miktionsbeschwerden als Harnröhrenenge interpretiert und behandelt [2]. Denn erst im Jahr 2004 wurde überhaupt erstmals eine praktikable Definiton einer infravesikalen Obstruktion vorgeschlagen [4]: Demnach liegt eine Obstruktion vor, wenn bei einem in der Urodynamik gemessenen Detrusordruck von mehr als 20 cm H 2 O ein Flow von weniger als 12 ml/s erreicht wird. Gleichzeitig muss das typische Bild einer Obstruktion im MCU vorliegen (.…”

Section: Inzidenz Und Klinikunclassified

Offene Harnröhrenchirurgie bei der Frau

Tritschler

Roosen

Bastian

et al. 2011

Urologe

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There are only a few disorders of the female urethra which have to be treated by open urethral surgery, urethral diverticula and urethral strictures. These diseases are rare and subsequently open surgery of the female urethra is also rare. However, these surgical techniques are an important part of the surgical armamentarium in urology, because this is the only method to preserve quality of life of patients concerned. Surgical therapy of urethral diverticula includes well-defined procedures, such as marsupialization and diverticula excision. In contrast, there is no established surgical therapy for female urethral strictures. Several suggestions to solve this problem have been made in recent years and will be presented in this article.

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Section: Inzidenz Und Klinikunclassified

Offene Harnröhrenchirurgie bei der Frau

Tritschler

Roosen

Bastian

et al. 2011

Urologe

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“…Studies in patients with primary bladder neck obstruction have shown fluoroscopic evidence of bladder neck obstruction with detrusor pressure at maximum flow rate of 20-70 cm H 2 O and low-flow maximum flow rate of less than 15 mL/s. Currently, the most refined urodynamic measures of BOO in women dictate a detrusor pressure at maximum flow rate of at least 25 cm H 2 O in combination with values of maximum flow rate of less than 12 mL/s [39]. Despite these eloquent determinations of UDS parameters for BOO, the UDS diagnosis of BOO is elusive after anti-incontinence surgery [40].…”

Section: Female Bladder Outlet Obstructionmentioning

confidence: 99%

Current Status of Urodynamics for Evaluation of Incontinence

Whittam

Kaufman

Dmochowski

2010

Curr Bladder Dysfunct Rep

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Urinary incontinence, defined by the International Continence Society as the complaint of any involuntary leakage of urine, remains a condition with profound impact for the individual patient and global medical economics. The etiology of a patient's urinary incontinence can be difficult to determine, even when using a combination approach of symptom appraisal, thorough history and physical examination, and noninvasive testing. Urodynamic evaluation provides an objective analysis of the storage and voiding aspects of detrusor function, often delineating the underlying mechanisms for bladder or sphincter dysfunction resulting in incontinence. This review summarizes current literature regarding recommendations for utilization of urodynamics in the evaluation of incontinence. Herein we recap the available data regarding use of urodynamics in intrinsic sphincter deficiency, overactive bladder, bladder outlet obstruction, and neurological disease. We intend for these data to highlight the need for a structured evaluation and treatment of urinary incontinence and appropriate use of resources to accommodate the dual missions of patient care and fiscal responsibility.

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“…Currently, there are no standardized criteria that reliably characterize bladder outlet obstruction in females with a high level of sensitivity or specifi city. Despite these limitations, several investigators have attempted to use urofl owmetry and pressure fl ow parameters to identify women with outfl ow obstruction, and several defi nitions have been proposed, with varying sensitivity and specifi city [26][27][28][29]. Some investigators have found that without the use of concomitant fl uoroscopy (FUDS) during the pressure fl ow study, nomograms may overestimate the true incidence of clinical obstruction and fail to identify patients with documented outfl ow obstruction.…”

Section: Urodynamic Evaluationmentioning

confidence: 99%

Overactive bladder symptoms following urethrolysis procedures

Starkman

2009

Curr Bladder Dysfunct Rep

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Female bladder outlet obstruction following stress urinary incontinence surgery is well described but requires a high index of suspicion given that patients often present clinically with both overactive bladder (OAB) and voiding symptoms. Furthermore, only 25% of patients have frank urinary retention that requires indwelling or clean intermittent catheterization. Historically, urethrolysis and sling lysis procedures ameliorate obstructive voiding symptoms with a success rate approaching 85% to 90%. In reviewing the literature, it has been my experience as well as those of other experts that OAB symptoms remain refractory in a signifi cant percentage of women, often leading to further invasive therapies and additional morbidity. This review describes the OAB symptom complex following urethrolysis procedures for outlet obstruction and discusses the incidence, pathophysiology, and management of this complex patient cohort.

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Refining Diagnosis of Anatomic Female Bladder Outlet Obstruction: Comparison of Pressure-Flow Study Parameters in Clinically Obstructed Women With Those of Normal Controls

Cited by 142 publications

References 0 publications

Offene Harnröhrenchirurgie bei der Frau

Offene Harnröhrenchirurgie bei der Frau

Current Status of Urodynamics for Evaluation of Incontinence

Overactive bladder symptoms following urethrolysis procedures

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