Investig Clin Urol.  2017 Jan;58(1):34-41. 10.4111/icu.2017.58.1.34.

The effect of posture and repetition on urodynamic parameters: A prospective randomized study

Affiliations
  • 1Department of Urology, Seoul National University Hospital, Seoul, Korea. sjo@snu.ac.kr
  • 2Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.

Abstract

PURPOSE
To evaluate the effect of posture and repetition of filling cystometry on urodynamic parameters.
MATERIALS AND METHODS
Seventy-one men with benign prostatic hyperplasia participated in a urodynamic study between September 2015 and August 2016 and were randomly assigned to a supine to supine (group SS, n=16), erect to erect (group EE, n=16), supine to erect (group SE, n=19) or erect to supine (group ES, n=20) group. The patients underwent filling cystometry twice. We evaluated the effect of posture and the effect of repetition on filling cystometric parameters. We also evaluated the correlation between overactive bladder (OAB) and detrusor overactivity (DO) and between maximum voided volume (MVV) and maximum cystometric capacity (MCC) for each posture and filling cystometry time.
RESULTS
There was a decrease in bladder sensation and occurrence of DO, and an increase in bladder compliance and MCC in the supine posture group compared to that in the erect posture group. A more significant decrease in bladder sensation and occurrence of DO as well as an increase in MCC was seen during the second filling cystometry than the first one. The supine posture during first filling cystometry showed a better correlation between OAB and DO and between MVV and MCC than erect posture.
CONCLUSIONS
There were clear effects of posture and filling cystometry repetition on urodynamic parameters. The supine posture and repeated filling cystometry caused the bladder to be less sensitive and less overactive. The supine posture showed a better correlation to OAB symptoms than erect posture during first filling cystometry.

Keyword

Lower urinary tract symptoms; Posture; Urodynamics

MeSH Terms

Compliance
Humans
Lower Urinary Tract Symptoms
Male
Posture*
Prospective Studies*
Prostatic Hyperplasia
Sensation
Urinary Bladder
Urinary Bladder, Overactive
Urodynamics*

Figure

  • Fig. 1 Scatter plot and intraclass correlation coefficient (ICC) between maximum voided volume (MVV) of frequency volume chart (FVC) and maximum cystometric capacity (MCC) of filling cystometry in each posture and filling cystometry time. (A) First supine, (B) first erect, (C) second supine, and (D) second erect.


Reference

1. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002; 21:167–178.
2. Nitti VW. Pressure flow urodynamic studies: the gold standard for diagnosing bladder outlet obstruction. Rev Urol. 2005; 7:Suppl 6. S14–S21.
3. Schäfer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A, et al. Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn. 2002; 21:261–274.
4. Winters JC, Dmochowski RR, Goldman HB, Herndon CD, Kobashi KC, Kraus SR, et al. Urodynamic studies in adults: AUA/SUFU guideline. J Urol. 2012; 188:6 Suppl. 2464–2472.
5. Hosker G, Rosier P, Gajewski J, Sand P, Szabo L, Capewell A. Dynamic testing. In : Abrams P, Cardozo L, Khury S, Wein A, editors. Incontinence: 4th International Consultation on Incontinence. Plymouth: Health Publications Ltd.;2009. p. 413–522.
6. Awad SA, McGinnis RH. Factors that influence the incidence of detrusor instability in women. J Urol. 1983; 130:114–115.
7. Al-Hayek S, Belal M, Abrams P. Does the patient's position influence the detection of detrusor overactivity? Neurourol Urodyn. 2008; 27:279–286.
8. Ockrim J, Laniado ME, Khoubehi B, Renzetti R, Finazzi Agrò E, Carter SS, et al. Variability of detrusor overactivity on repeated filling cystometry in men with urge symptoms: comparison with spinal cord injury patients. BJU Int. 2005; 95:587–590.
9. Seoul National University Hospital Biomedical Research Institute [Internet]. Seoul: Medical Research Collaborating Center Seoul National University Hospital;c2004. cited 2004 Aug 1. Available from: http://mrcc.snuh.org/.
10. Yamaguchi O, Nishizawa O, Takeda M, Yokoyama O, Homma Y, Kakizaki H, et al. Clinical guidelines for overactive bladder. Int J Urol. 2009; 16:126–142.
11. Lim CS, Abrams P. The Abrams-Griffiths nomogram. World J Urol. 1995; 13:34–39.
12. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977; 33:159–174.
13. Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess. 1994; 6:284–290.
14. Abrams P. Describing bladder storage function: overactive bladder syndrome and detrusor overactivity. Urology. 2003; 62:5 Suppl 2. 28–37.
15. Geirsson G, Fall M. Reflex interaction between the proximal urethra and the bladder. A clinical experimental study. Scand J Urol Nephrol. 1999; 33:24–26.
16. Yıldız N, Alkan H, Sarsan A, Alkan S. The effects of repeated filling cystometries on cystometric variables in spinal cord-injured patients with overactive detrusor, who utilize different type of urine drainage methods. Spinal Cord. 2015; 53:625–629.
17. Henderson E, Drake M. Overactive bladder. Maturitas. 2010; 66:257–262.
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