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Zeroing Pressures in Urodynamics: Revisiting Current Practice and Pressure Interpretation
Lucas Antonio Pereira do Nascimento1, Vicktor Bruno Pereira Pinto1, Carlos Henrique Costa1
1Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
Neurourology and Urodynamics
|July 31, 2026
Summary
Atmospheric zeroing and in vivo zeroing in urodynamics yield similar results. Both methods are suitable for accurate urodynamic testing, despite differing baseline values, suggesting current recommendations may lack comparative outcome data.
Area of Science:
- Urology
- Medical Devices
- Diagnostic Techniques
Background:
- Zeroing pressure transducers is crucial for accurate urodynamic testing.
- Atmospheric zeroing (before catheter insertion) is conventional, but in vivo zeroing (catheters in situ) is also practiced.
- The impact of different zeroing techniques on urodynamic interpretation requires clarification.
Purpose of the Study:
- To review the basis of atmospheric zeroing in urodynamics.
- To explore whether in vivo zeroing affects urodynamic interpretation.
- To compare atmospheric and in vivo zeroing techniques.
Main Methods:
- A structured literature review of PubMed and SciELO (1968-Jan 2025) identified 20 relevant studies.
- Qualitative synthesis of selected literature and methodological documents.
- Comparative analysis of atmospheric and in vivo zeroing in three illustrative urodynamic cases.
Main Results:
- No studies directly compared atmospheric and in vivo zeroing.
- Conceptual arguments for atmospheric zeroing were not supported by outcome data.
- Illustrative cases showed similar key urodynamic parameters and diagnostic conclusions despite different baseline values.
Conclusions:
- Current recommendations for atmospheric zeroing lack comparative outcome data.
- Both atmospheric and in vivo zeroing appear capable of producing sound urodynamic studies in water-filled systems.
- Further research is needed on diagnostic agreement, user experience, and pressure tracing clarity.
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