4 research outputs found
External Urethral Sphincter Pressure Measurement: An Accurate Method for the Diagnosis of Detrusor External Sphincter Dyssynergia?
Combined pelvic floor electromyography (EMG) and videocystourethrography (VCUG) during urodynamic investigation are the most acceptable and widely agreed methods for diagnosing detrusor external sphincter dyssynergia (DESD). Theoretically, external urethral sphincter pressure (EUSP) measurement would provide enough information for the diagnosis of DESD and could simplify the urodynamic investigation replacing combined pelvic floor EMG and VCUG. Thus, we evaluated the diagnostic accuracy of EUSP measurement for DESD. PATIENTS #ENTITYSTARTX00026;A consecutive series of 72 patients (36 women, 36 men) with neurogenic lower urinary tract dysfunction able to void spontaneously was prospectively evaluated at a single university spinal cord injury center. Diagnosis of DESD using EUSP measurement (index test) versus combined pelvic floor EMG and VCUG (reference standard) was assessed according to the recommendations of the Standards for Reporting of Diagnostic Accuracy Initiative.Using EUSP measurement (index test) and combined pelvic floor EMG and VCUR (reference standard), DESD was diagnosed in 10 (14%) and in 41 (57%) patients, respectively. More than half of the patients presented discordant diagnosis between the index test and the reference standard. Among 41 patients with DESD diagnosed by combined pelvic floor EMG and VCUR, EUSP measurement identified only 6 patients. EUSP measurement had a sensitivity of 15% (95% CI 5%-25%), specificity of 87% (95% CI 76%-98%), positive predictive value of 60% (95% CI 30%-90%), and negative predictive value of 56% (95% CI 44%-68%) for the diagnosis of DESD.For diagnosis of DESD, EUSP measurement is inaccurate and cannot replace combined pelvic floor EMG and VCUR
An 8 French transurethral reusable microtip dual sensor microtransducer catheter (Unisensor AG, Attikon, Switzerland) was used to simultaneously measure the intravesical and urethral pressure.
<p>The microtransducers were positioned in the bladder (a) and the external urethral sphincter (b) under the guidance of continuous pressure monitoring and fluoroscopy ensuring correct position during the urodynamic investigation.</p
Standards for Reporting of Diagnostic Accuracy flow diagram.
<p><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0037996#pone.0037996-Bossuyt1" target="_blank">[8]</a> Comparison of external urethral sphincter pressure (EUSP) measurement (index test) versus combined pelvic floor electromyography (EMG) and videocystourethrography (VCUR) (reference standard) for the diagnosis of detrusor external sphincter dyssynergia (DESD).</p
Urodynamic parameters of the 72 patients included in the study.
<p>SD: standard deviation.</p