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SYMPOSIUM
Year : 2009  |  Volume : 25  |  Issue : 1  |  Page : 83-91

Review of invasive urodynamics and progress towards non-invasive measurements in the assessment of bladder outlet obstruction


1 Department of Medical Physics, Freeman Hospital, Newcastle upon Tyne, United Kingdom
2 School of Surgical and Reproductive Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom

Correspondence Address:
C J Griffiths
Department of Medical Physics, Freeman Hospital, Newcastle upon Tyne, NE7 7DN
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.45544

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Objective: This article defines the need for objective measurements to help diagnose the cause of lower urinary tract symptoms (LUTS). It describes the conventional techniques available, mainly invasive, and then summarizes the emerging range of non-invasive measurement techniques. Methods: This is a narrative review derived form the clinical and scientific knowledge of the authors together with consideration of selected literature. Results: Consideration of measured bladder pressure urinary flow rate during voiding in an invasive pressure flow study is considered the gold standard for categorization of bladder outlet obstruction (BOO). The diagnosis is currently made by plotting the detrusor pressure at maximum flow (p detQmax ) and maximum flow rate (Q max ) on the nomogram approved by the International Continence Society. This plot will categorize the void as obstructed, equivocal or unobstructed. The invasive and relatively complex nature of this investigation has led to a number of inventive techniques to categorize BOO either by measuring bladder pressure non-invasively or by providing a proxy measure such as bladder weight. Conclusion: Non-invasive methods of diagnosing BOO show great promise and a few have reached the stage of being commercially available. Further studies are however needed to validate the measurement technique and assess their worth in the assessment of men with LUTS.


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