abstract407 - COMPARISON OF WATER & AIR-CHARGED TRANSDUCER CATHETERS IN THE EVALUATION OF URETHRAL PRESSURES & ISD
COMPARISON OF WATER &AIR-CHARGED TRANSDUCER CATHETERS IN THE EVALUATION OF URETHRALPRESSURES & ISD
T. B. MCKINNEY1, E.BABIN 2, N. M. SHAH 3, C. R. MCKINNEY 4,V. CIOLFI 5;
1FEMALE PELVIC MEDICINE &RECONSTRUCTIVE SURGERY, Drexel Univ. Sch. of Med., Philadelphia, FL,2Drexel Univ. Sch. of Med., Philadelphia, PA, 3DrexelUniv. Coll. of Med., Philadelphia, PA, 4Drexel Univ. Sch.of Med., Philadelphia, FL, 5Clinical Research, DrexelUniv. Sch. of Med., Philadelphia, FL.
Introduction: Previous studieshave investigated the differences between air-charged (AC) andwater-perfused (WP) catheter; however, this study introduces a singlecatheter technique to overcome the limitations ofdouble-catheterization including better patient comfort, decreasedalteration of the natural urethral closure mechanism and a lessenedrisk of catheter cross-talk. Previously, the Cough and Valsalva ( R2= 0.97) and Voiding Pressure studies ( R2 = 0.99)using simultaneous Pves pressures where found to beequivalent
Objective: The aim of this study is to determineif there is a significant difference between AC and WP urethralpressure profiles (UPP) and ISD diagnosis in urodynamic studies(UDS).
Methods: This IRB approved prospective studyrecruited women above the age of 21 with lower urinary tract symptomsin whom UDS was deemed necessary for diagnostic workup. All UDS wereconducted based upon Good Urodynamic Practices. A commerciallyavailable Dual AC catheter was utilized and a three-way stopcock tosimultaneously read water and air pressures within the bladder andurethra. The water-filling channel serves both as a bladder fillerand water pressure sensor. A minimum of 3 consecutive UPPs weremeasured at a bladder volume of 200 mL and included in analysis. Acomparative analysis was performed to acquire MUCP and maximumurethral pressures (MUP).
Results: For this series, 50women with a mean age of 57 years were recruited. Correlations arepresented between AC and WP pressures ( N = 147) as shown in Figure1. AC pressures are on average 8.2 cmH2O (MUP) and 10.97 cmH20 (MUCP)higher than WP. A strong correlation was found between AC and WPpressures for the measures of MUP (R2=0.9215) and MUCP (R2=0.9217),respectively. Figure 2 display the reproducibility of consecutivepull-through for MUP while comparing AC and WP, indicating thereproducibility is not significantly different. Intrinsic SphincterDeficiency, however, was over diagnosed with H2O MUCP data vs. LPPdata population (6/50 ) ( Fig. 3).
Conclusions: Urethralpressures measured using AC catheters are highly correlated andclinically equivalent to WP catheters. AC produces MUP/MUCP pressuresthat are on average 9.25cmH20 higher. ISD appears to be overdiagnosed with H2O catheters using only MUCP’s.
References:1. Int Urogynecol J (2014) 25(1); 123-30. 2. Neurourol Urodyn (2002)21(3):261-74. 3. Int Urogynecol J (2014) 15(2):124-8.