ORIGINAL ARTICLE   

Minerva Urology and Nephrology 2021 October;73(5):655-61

DOI: 10.23736/S2724-6051.20.03838-2

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Artifacts and abnormal findings may limit the use of asymptomatic volunteers as controls for studies of multichannel urodynamics

Natalie R. SWAVELY ¹, John E. SPEICH ², Adam P. KLAUSNER ¹ ✉

¹ Virginia Commonwealth University School of Medicine, Division of Urology, Department of Surgery, Richmond, VA, USA; ² Virginia Commonwealth University School of Engineering, Department of Mechanical and Nuclear Engineering, Richmond, VA, USA

BACKGROUND: Multichannel urodynamics is the gold standard for the evaluation of lower urinary tract symptoms (LUTS). When performing studies to validate new adjuncts to urodynamic testing with control patients undergoing urodynamic investigation, there is difficulty in the interpretation of urodynamic results in the asymptomatic patient due to artifacts and the invasive nature of the procedure. The purpose of this investigation was to examine urodynamics in asymptomatic volunteers in order to better understand the role of control participants in urodynamic research studies.
METHODS: Asymptomatic volunteers with no LUTS were recruited to undergo standard urodynamic testing as a comparison group in a study evaluating novel urodynamic techniques. To be eligible, participants had to report no LUTS, score ≤1 on all symptom questions of the International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIq-OAB) survey, have no medical conditions or to undergo any medications that affect bladder function. The urodynamics was done according to ICS standards. All tracings were evaluated by an expert neuro-urologist. Data were analyzed categorically for the presence or absence of low compliance (<30 mL/cmH20), detrusor overactivity, bladder outlet obstruction (Bladder Outlet Obstruction Index [BOOI]>40), weak contractility (bladder contractility index [BCI]<100), straining to void, poorly sustained detrusor contraction, uncoordinated EMG activity, and intermittent flow.
RESULTS: A total of 24 participants completed the study including 10 men and 14 women. All participants had at least 1 urodynamic abnormality/artifact with an average of 4.43±1.28 abnormalities/participant. The most common abnormalities included uncoordinated electromyography (EMG) activity (87.50%), straining to void (79.17%), and intermittent flow (70.83%). There were no significant differences for sex, age, Body Mass Index.
CONCLUSIONS: This study demonstrated that healthy, asymptomatic volunteers have high rates of abnormal urodynamic findings, suggesting that asymptomatic participants are not the ideal controls in research studies that involve urodynamic testing.

KEY WORDS: Urodynamics; Urinary bladder, overactive; Lower urinary tract symptoms; Diagnosis; Urinary bladder neck obstruction