The reproducibility of urodynamic findings in healthy female volunteers: Results of repeated studies in the same setting and after short term follow-up
The reproducibility of urodynamic findings in healthy female volunteers: Results of repeated studies in the same setting and after short term follow-up
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DOI：
10.1002/nau.20039
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发表时间：
2004-01-01
影响因子：
2
通讯作者：
Lemack, GE
中科院分区：
文献类型：
--
作者：
Gupta, A;Defreitas, G;Lemack, GE
目的：评估无症状健康女性志愿者尿动力学 (UD) 检测的即时（相同检测周期）和短期（6 个月内）可重复性。材料和方法：20 名平均年龄为 41.8 岁 (30-55) 的无症状女性同意接受 UD 评估，其中包括无创尿流测定、排尿后残余 (PVR) 测量、中等充盈膀胱测压和会阴表面肌电 (EMG) 电极压力流量研究。立即重复 UDS 评估，无需移除导管（两次填充和排空研究）。 1-5 个月后，16 名女性返回进行相同的 UD 评估。通过计算重复性系数 (COR) 来评估 UD 参数的即时和短期重复性。结果：无法计算立即 UD 测试的某些参数的重复性，因为第一个测试对第二个测试有明显的影响（即膀胱充盈量中注意到明显的调节）。其他即时 UD 值（最大流量、最大流量时的逼尿肌压力、排尿量）具有较高的 COR 值，短期测试中的所有 UD 值也是如此，表明重复性相对较差。选择“最佳”压力流量值（伴随逼尿肌压力的最高流量）并不能持续改善 COR 值。结论： UD 研究缺乏可重复性可能是由于膀胱功能的真实生理波动和我们的仪器在进行这些测试时固有的相对不敏感性的结合。了解当前技术的局限性对于我们更好地利用这些研究来评估患者并进一步改进诊断策略至关重要。 (C) 2004 Wiley-Liss, Inc.
Aim: To assess the immediate (same testing period) and short-term (within 6 months) repeatability of urodynamic (UD) testing in asymptomatic healthy female volunteers. Materials and Methods: Twenty asymptomatic women with a mean age of 41.8 years (30-55) agreed to undergo a UD assessment which consisted of noninvasive uroflowmetry, post-void residual (PVR) measurement, medium-fill cystometry, and pressure flow study with perineal surface electromyographic (EMG) electrodes. The UDS evaluation was repeated immediately without removing the catheters (a two-fill and void study). Sixteen women returned for an identical UD assessment 1-5 months later. Immediate and short-term repeatability of UD parameters was assessed by calculating the coefficient of repeatability (COR). Results: The repeatability of certain parameters of immediate UD testing could not be calculated since there was an apparent influence of the first test on the second (i.e., an apparent accommodation noted in bladder filling volumes). Other immediate UD values (maximum flow, detrusor pressure at maximum flow, voided volume) had high COR values, as did all UD values on short-term testing, indicating relatively poor repeatability. Picking the `best' pressure flow value (highest flow rate with accompanying detrusor pressure) did not consistently improve the COR values. Conclusions: The lack of repeatability of UD studies likely stems from a combination of the true physiological fluctuations in bladder function and the inherent relative insensitivity of our instruments in conducting these testing. Knowledge of the limitations of current technology is essential in allowing us to better utilize these studies in evaluating our patients and further improving diagnostic strategies. (C) 2004 Wiley-Liss, Inc.