Typical value ranges and signal patterns in patients with neurogenic bladder: Quality control in urodynamics using an...

To establish typical value ranges (TVRs) of the air-charged catheter (ACC) system, and analyze the typical signal patterns (TSPs) of cough under different bladder volumes for quality control of a urodynamic study using the ACC system.

The urodynamic traces of 1977 patients with neurogenic bladder (NB) were analyzed for intravesical pressure (p_ves ), abdominal pressure (p_abd ), and detrusor pressure (p_det ) in the cough test at our center from July 2017 to December 2021. The p_det cough signals were described and classified. The p_det cough signal patterns in different bladder volumes and postures were analyzed.

The 50% range of the initial resting p_ves , p_abd , and p_det in the supine and sitting positions were 7-15, 7-14, and 0-0 cmH₂ O, and 24-33, 24-33, and 0-0 cmH₂ O, respectively. The cough amplitudes for p_ves and p_abd were similar in the 50% range, as follows: 10-27 and 8-25 cmH₂ O in the supine position, respectively; and 18-43 and 17-40 cmH₂ O in the sitting position, respectively. The cough amplitude of p_ves and p_abd was not related to bladder volume (p > 0.05). The cough spikes of p_det were divided into three types: type I, in which p_det has a minimal change (<5 cmH₂ O); type II, a monophasic cough spike, in which could be a positive (IIa, ≥5 cmH₂ O) or negative spike (IIb, ≥5 cmH₂ O); and type III, a biphasic spike, in which could be a positive-to-negative biphasic (IIIa) or negative-to-positive spike (IIIb). Under different bladder volumes, the cough signals of p_det were all expressed as type I, II, or III, and the cough signals were unrelated to bladder volume (p > 0.05).

TVRs of the initial resting state in patients with NB were established to provide guidance for quantitative quality control of the ACC system. The TSPs of the p_det cough signal under different bladder volume and posture were described, which could be used for qualitative quality control of the ACC system.