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The Value of Urethral Pressure Profile Using Air-Charged Catheters in the Diagnosis of Female Bladder Neck
Yan Qin1,2, Fei Wang1, Chaohua Zhang1
1Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Objectives:
Rarely have studies focused on the utilization of urethral pressure profile (UPP) in bladder neck obstruction (BNO). This study aimed to evaluate the parameters of UPP in urodynamic testing (UDS) using air-charged catheters (ACC) and to investigate the value of UPP as a diagnostic tool for female BNO.
Patients And Methods:
We retrospectively collected records of 165 female patients with lower urinary tract symptoms (LUTS) who received UDS at our center from September 2020 to September 2022. The whole patient group was divided into BNO group (n = 92) and non-BNO group (n = 73). The urodynamic data were evaluated.
Results:
The UPP includes urethral pressures at the bladder neck (b-UP) and urethral sphincter (s-UP). The b-UP was higher in the BNO group than in the non-BNO group [104.50 (40.50) cmH2O vs. 58.00 (33.50) cmH2O, p < 0.001]. According to multivariable logistic regression analysis, b-UP and bladder voiding efficiency (BVE) were independently associated with BNO. The area under the curve (AUC) of the b-UP had the best value for predicting BNO [AUC: 0.878, sensitivity: 88.04%, specificity: 76.71%, 95% confidence interval (CI): 0.819-0.924]; its cut-off value was 72 cmH2O. Meanwhile, Cohen's kappa was 0.65 (95% CI: 0.537-0.770), indicating that UPP as a diagnostic tool was highly consistent with the video-urodynamic study (VUDS).
Conclusions:
UPP by air-charged urodynamic catheters can show the pressure of the bladder neck, with predictive value for identifying BNO in women. The predictive method based on UPP and pressure-flow study (PFS) without fluoroscopy will improve the diagnostic accuracy of BNO, which could help urologists in making better clinical decisions.
