Retrospective evaluation of clinical performance of three measurement catheter fixation methods in urodynamic studies

Catheter displacement during urodynamic studies remains a common challenge, potentially introducing artifacts, compromising test accuracy, and decreasing patient comfort. Despite the clinical significance of stable catheter fixation, evidence-based recommendations for optimal fixation techniques are lacking. This study seeks to address this gap by comparing the effectiveness and patient comfort associated with three commonly used catheter fixation methods during urodynamic study.

We retrospectively collected data from non-randomized patients who underwent urodynamic studies (UDS) at West China Hospital of Sichuan University between April and June 2023. Patients were selected based on predefined inclusion and exclusion criteria and assigned to one of three catheter fixation methods. The effectiveness of the following fixation techniques was evaluated: waterproof tape fixation (Group 1: catheter secured to the skin with adhesive tape), (2) patient-manual fixation (Group 2: patient holds the catheter manually throughout the procedure), and (3) silk thread fixation (Group 3: catheter secured with silk suture tied and fixed externally).

A total of 168 patients were enrolled in the study, with 56 patients in each group. The median ages for Groups 1, 2, and 3 were 66 (47.25, 76), 67 (61,71), and 66 (48, 76.75) years, respectively. There were no statistically significant differences among the three groups in terms of maximum cystometric capacity (MCC), bladder compliance (BC), maximum flow rate (Qmax), detrusor pressure at Qmax (Pdet.Qmax), bladder contractility index (BCI), or bladder outlet obstruction index (BOOI) (P > 0.05). The overall incidence of catheter displacement was 35.71% in Group 1, 0% in Group 2, and 14.29% in Group 3. Statistically significant differences in Comfort-B scale scores were observed between Group 1 and Group 2, and between Group 2 and Group 3 (P < 0.000). Similarly, visual analogue scale (VAS) scores also showed significant differences between Group 1 and Group 2, and between Group 2 and Group 3 (P < 0.000).

Our preliminary assessment indicated that the three catheter fixation methods did not significantly influence urodynamic parameters. Notably, patient-manual fixation achieved the lowest catheter displacement rate (0%) but was associated with the highest pain and discomfort scores. In contrast, waterproof tape and silk thread fixation offered better patient comfort but with higher displacement rates. These findings highlight a trade-off between catheter stability and patient comfort, suggesting that fixation method selection should be individualized based on patient characteristics and procedural requireme.

Not applicable.