Evaluation of cervico-urethral obstruction with ambulatory pressure/flow studies: an alternative to conventional...

Most of the urodynamic studies are conducted in the laboratory during a brief recording time and under nonphysiological conditions and, thus, may fail to unfold the nature of existing pathological conditions of the lower urinary tract; false positives and false negatives are possible. To overcome some of the difficulties associated with conventional P/F studies we have developed, with the cooperation of Medical Measurement System company, Entschede, The Netherlands, a portable system (UDS 2000) for ambulatory monitoring of intravesical pressure, abdominal pressure and EMG connectable with a weight-transducer flowmeter that allows to perform Holter P/F measurements. We compared the results obtained with conventional P/F studies and with Holter P/F studies in 58 BPH patients. During the filling phase we observed a slightly increased number of stable detrusors with Holter P/F recording (46 vs 42); conversely, the number of patients suffering from urge incontinence was the same (7 pts). During the voiding phase, out of 45 patients considered obstructed at conventional P/F study, only 42 were really urodynamically obstructed (93.3%), while other 3 patients had bordeline obstruction. 4 patients with bordeline obstruction at conventional P/F study were considered non-obstructed after Holter P/F. In conclusion, Holter P/F proved to be reliable in the assessment of bladder function during storage and emptying in BPH patients and to be more specific in defining outlet obstruction than the conventional study because of the physiologic filling, the reduction of urethral irritation, the lack of a urethral catheter either during filling or voiding, and the reduction of emotional stress.(ABSTRACT TRUNCATED AT 250 WORDS)