Large-scale Application of the condom catheter method for Non-invasive Urodynamics in a Longitudinal Study of Changes in Bladder Contractllity Secondary to Benign Prostatic Enlargement

In a longitudinaal study the changes of bladder muscle contracticity in response to increasing obstruction of the lower urinary tract caused by prostatic enlargement were studies using non-invasive urodynamics

Increased postvoid residual volume after measuring the isovolumetric bladder pressure using the noninvasive condom catheter method

OBJECTIVE: To test, in an ongoing noninvasive longitudinal study in healthy men, whether the condom catheter method (a noninvasive urodynamic test to assess bladder function and bladder outlet obstruction) inhibits bladder function and whether this affects the reliability of the measured isovolumetric bladder pressure (P(ves.iso)). SUBJECTS AND METHODS: Subjects (754, aged 40-79 years) voided three times, i.e. one free void and two condom measurements. The postvoid residual volume (PVR) was measured after each void using transabdominal ultrasonography. The statistical significance of differences was tested using Wilcoxon rank test and the Mann-Whitney U-test. RESULTS: After free voiding the median (interquartile range) PVR was 18 (37) mL, and independent of the amount of fluid intake. In a subgroup of volunteers, when the free void was done last, the PVR was no different (P = 0.25), suggesting that the bladder did not become exhausted during the protocol. The PVR after two subsequent condom measurements was significantly higher than after free voiding, at 45 (78) and 57 (88) (both P < 0.05), independent of the number of interruptions in voiding. After supplementary fluid intake before the condom measurements, the PVR was double that with a normal fluid intake (P = 0.03). The median P(ves.iso) was 3 cmH(2)O higher in the second condom measurement than in the first (P < 0.05), although this small difference was not clinically relevant. CONCLUSIONS: The condom measurement is associated with a significantly higher PVR, partly caused by supplementary fluid intake. This effect was only temporary and did not affect the measured P(ves.iso)

Epidemiological aspects of recruitment of male volunteers for non-invasive urodynamics

Introduction: We studied epidemiological aspects of recruitment of volunteers for a non-invasive urodynamic study. Materials and Methods: 9,236 volunteers were invited by 20 general practitioners (GPs), using two different recruitment methods, i.e. by mail only, or during a subsequent visit to the GP's office. Factors influencing the response rates were analyzed. We also tested how much the recruited population of volunteers differed from the general population, by comparing it to another, proven representative study carried out earlier in 1,662 subjects. Results: In the recruited population the prostate volumes were not significantly different from the proven representative study, but the symptom score was statistically significantly higher, although the difference was so small it may be called clinically irrelevant. Recruitment of volunteers in two steps, i.e. asking them first to visit the GP's office, and inviting them there to visit the outpatient clinic, rather than directly inviting them (in writing) to the clinic seemed to lead to a higher response, although this effect could not be statistically discriminated from the difference in response rates between GPs. Conclusion: The population recruited was not urologically different from the general population. The response depended on age, being highest around the age of 60, and increased with social economic status. It also depended on the GP who recruited the subjects, and/or on the recruitment method. Copyrigh

Correlations between the Various Methods of Estimating Prostate Volume: Transabdominal, Transrectal, and Three-Dimensional US

OBJECTIVE: To evaluate the correlations between prostate volumes estimated by transabdominal, transrectal, and three-dimensional US and the factors affecting the differences. MATERIALS AND METHODS: The prostate volumes of 94 consecutive patients were measured by both transabdominal and transrectal US. Next, the prostate volumes of 58 other patients was measured by both transrectal and three-dimensional US. We evaluated the degree of correlation and mean difference in each comparison. We also analyzed possible factors affecting the differences, such as the experiences of examiners in transrectal US, bladder volume, and prostate volume. RESULTS: In the comparison of transabdominal and transrectal US methods, the mean difference was 8.4 +/- 10.5 mL and correlation coefficient (r) was 0.775 (p 0.05). The comparison between the transrectal and three-dimensional US methods revealed a mean difference of 3.7 +/- 3.4 mL and the correlation coefficient was 0.924 for the experienced examiner. Furthermore, no significant difference existed between examiners (p > 0.05). Prostate volume measured by transrectal US showed a positive correlation with the difference for the beginner only (r = 0.405, p < 0.05). CONCLUSION: In the prostate volume estimation by US, experience in transrectal US is important in the correlation with transabdominal US, but not with three-dimensional US. Also, less experienced examiners' assessment of the prostate volume can be affected by prostate volume itself