Comparison of flowrates and voided volumes during non-instrumented uroflowmetry and pressure-flow studies in women with stress incontinence

Elizabeth R. Mueller, Heather Litman, Leslie R. Rickey, Larry Sirls, Peggy Norton, Tracey Wilson, Pamela Moalli, Michael Albo, Philippe Zimmern
2014 Neurourology and Urodynamics  
Aims-The Blaivas-Groutz nomogram defines voiding obstruction in women using Q max from the NIF and the maximum detrusor pressure (P detmax ) from the PFS. The aim of this study was to understand the relationship between NIF and PFS maximum flow rates in women with stress incontinence. Methods-We analyzed the UDS of 597 women with stress-dominant urinary incontinence. Each subject underwent a NIF and then a PFS. Mixed model was used to test the hypothesis that the relationship between flow rates
more » ... and voided volume were similar for NIF and PFS. Results-There were 452 subjects with both NIF and PFS studies that met the inclusion criteria and had max flow rate (Q max ) for both NIF and PFS. The mean age was 53. Overall, higher voided volumes were observed during PFS compared to NIF and subjects had higher Q max with NIF compared to PFS. The relationship between Q max and VV was significantly different between NIF and PFS (p < 0.004). At 200 mL, NIF Q max was 14% higher than PFS Q max and this difference increased to 30% at 700mL. Conclusion- The difference between PFS Q max and NIF Q max increases as voided volumes increase. As a result, values from PFS and NIF cannot be used interchangeably as has been suggested in the Blaivas-Groutz nomogram for obstruction in women. MESA questionnaire NIF non-instrumented uroflow PFS pressure flow studies VV voided volumes Q max Maximum flow rate POP-Q Prolapse stages T Qmax the median time to Q max Mueller et al. peak and average flow rates CARE Colpopexy and Urinary Reduction Efforts SPUI stress predominant urinary incontinence UITN Urinary Incontinence Treatment Network SUI stress urinary incontinence POP Pelvic organ prolapse CMG filling cystometry ANCOVA analysis of covariance MCC Maximum cystometric capacity SUI supervoiders
doi:10.1002/nau.22625 pmid:24797058 pmcid:PMC4219932 fatcat:6jstpwfl3fcufd35bdnprclkv4