Minerva Urologica e Nefrologica 2020 Jul 07

DOI: 10.23736/S0393-2249.20.03838-2

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

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

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

BACKGROUND: Multi-channel urodynamics is the gold-standard for the evaluation of LUTS. When performing studies to validate new adjuncts to urodynamic testing with control patients undergoing urodynamic investigation there is difficulty in 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 ICIq-OAB survey, have no medical conditions or be on 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 (< 30ml/cmH20), detrusor overactivity, bladder outlet obstruction (BOOI > 40), weak contractility (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 EMG activity (87.50%), straining to void (79.17%), and intermittent flow (70.83%). There were no significant differences for sex, age, BMI.
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; Detrusor overactivity; Lower urinary tract symptoms/diagnosis; Urinary bladder; Overactive/diagnosis; Urinary bladder neck obstruction/diagnosis