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One Size Does Not Fit All: Establishing Anticipated Baseline Intravesical Pressures Adjusted for Position and Body
Parker Holum1, Soutik Ghosal2, Lucie T Lefbom1
1University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Neurourology and Urodynamics
|July 27, 2026
Summary
Accurate intravesical pressure (Pves) measurement during urodynamic testing is influenced by body mass index (BMI). New reference ranges, varying with BMI, age, sex, and position, were established for resting Pves.
Area of Science:
- Urology
- Medical Measurement
- Biostatistics
Background:
- Accurate intravesical pressure (Pves) measurement is crucial for multichannel urodynamic testing.
- Establishing reliable reference ranges for Pves is essential for clinical interpretation.
- Factors like patient position and body composition can influence Pves readings.
Purpose of the Study:
- To prospectively evaluate baseline resting Pves in supine and sitting positions.
- To establish reference ranges for Pves using statistical modeling.
- To examine the influence of age, sex, and BMI on Pves measurements.
Main Methods:
- Prospective evaluation of adults undergoing multichannel urodynamic testing.
- Standardized protocol for recording resting Pves in supine and sitting positions using external dome transducers.
- Linear mixed-effects prediction models to analyze associations between Pves and patient characteristics (age, sex, BMI, position).
Main Results:
- The study included 468 patients, with 77% being overweight or obese.
- Mean supine Pves was 12.7 cmH2O and mean sitting Pves was 26.0 cmH2O.
- Increasing BMI strongly correlated with increasing Pves; model-derived normal Pves ranges were established for supine (0.0-26.6 cmH2O) and sitting (7.3-43.6 cmH2O) positions.
Conclusions:
- Model-derived reference ranges for resting Pves are primarily influenced by BMI.
- Patients with higher BMIs may exceed current guideline-recommended Pves thresholds.
- An online application was developed to generate expected Pves ranges based on individual patient characteristics.
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