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Related Experiment Videos

Relative bladder outlet obstruction.

Ries Kranse1, Ron van Mastrigt

  • 1Department of Urology-Urodynamics, Erasmus University Rotterdam, Rotterdam, The Netherlands.

The Journal of Urology
|July 20, 2002
PubMed
Summary

A new method defines bladder outlet obstruction using post-void residual urine, offering a relative measure of urethral resistance factor (URA) to bladder contractility (w20). This approach provides distinct thresholds for females and males to identify obstruction.

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Area of Science:

  • Urology
  • Physiology

Background:

  • Current male bladder outlet obstruction definitions rely on the International Continence Society nomogram, a mix of expert opinion and pre/post-surgical measurements.
  • There is a growing need for a similar diagnostic nomogram for female bladder outlet obstruction.

Purpose of the Study:

  • To investigate the potential of using post-void residual urine as an indicator for defining bladder outlet obstruction.
  • To develop a new nomogram for diagnosing bladder outlet obstruction in both males and females.

Main Methods:

  • Modeled the probability of post-void residual urine exceeding 20% of bladder capacity in males and females.
  • Utilized the ratio of urethral resistance factor (URA) to the Watts factor at 20% (w20) as a key parameter (URA/w20).
  • Established thresholds for URA/w20 to define relative obstruction.

Main Results:

  • Identified specific URA/w20 thresholds: 6.8 for females and 8.2 for males, above which post-void residual urine exceeded 20% in 90% of cases.
  • Developed a transformed International Continence Society nomogram for females, featuring horizontal lines indicating flow rate independence.
  • Demonstrated that relative obstruction can be defined based on bladder contractility.

Conclusions:

  • Recommends defining bladder outlet obstruction relatively, based on bladder contractility, rather than as an absolute level of resistance.
  • The proposed URA/w20 parameter and established thresholds offer a new approach to diagnosing bladder outlet obstruction in both sexes.
  • The female nomogram, though horizontal, shares similar intercepts with the male nomogram, suggesting potential for gender-specific but comparable diagnostic criteria.

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