Objective: To evaluate the efficacy of uroflowmetry performed through an indwelling catheter on the differential diagnosis of detrusor acontractility. Patients and Methods: 50 men aged between 51 and 85 years (mean 66 years) presenting to the outpatient urology department with indwelling catheters due to urinary retention were included in the study. In the supine position, 300 ml of saline was instilled into the bladder and the catheter was blocked; with the patient standing by the flowmeter, the catheter was opened, allowing the patient to void through the catheter. The evaluation continued with a cystometry and pressure-flow study (PFS). The patients were separated into two groups according to the results of the PFS - group 1 with positive detrusor pressure and group 2 with negative detrusor pressure (detrusor acontractility) - and the catheterized uroflow and PFS data were compared. Results: Statistical significance was seen between detrusor acontractility and peak flow rate (Qmax) on catheterized uroflow when Qmax <10 ml/s was taken as a threshold value (p = 0). Conclusion: A quick, noninvasive and inexpensive means of assessing lower urinary tract function would improve the management of men needing PFS. This study reveals that catheterized uroflow is a very easy and useful test if the question is whether the bladder is acontractile or not.

Keywords:
Bladder dysfunction, Pressure-flow study, Urodynamic study, Uroflowmetry
1.
Emberton M, Neal DE, Black N, Fordham M, Harrison M, McBrien MP, Williams RE, McPherson K, Devlin HB: The effect of prostatectomy on symptom severity and quality of life. Br J Urol 1996;77:233-247.
2.
Mohsin Rizvi R, Chughtai NG: Reliability of urodynamic interpretation in women presenting with urinary incontinence at a tertiary hospital. Urol Int 2012;88:410-414.
3.
Schäfer W: Urethral resistance? Urodynamic concepts of physiological and pathological bladder outlet function during voiding. Neurourol Urodyn 1985;4:161-201.
4.
Mosso A, Pellacani P: On bladder function. 1882.
5.
Sirls LT, Kirkemo AK, Jay J: Lack of correlation of the American Urological Association Symptom 7 Index with urodynamic bladder outlet obstruction. Neurourol Urodyn 1996;15:447-456; discussion 457.
6.
van Venrooij GE, Boon TA: The value of symptom score, quality of life score, maximal urinary flow rate, residual volume and prostate size for the diagnosis of obstructive benign prostatic hyperplasia: a urodynamic analysis. J Urol 1996;155:2014-2018.
7.
Chancellor MB, Blaivas JG, Kaplan SA, Axelrod S: Bladder outlet obstruction versus impaired detrusor contractility: the role of outflow. J Urol 1991;145:810-812.
8.
Gerstenberg TC, Andersen JT, Klarskov P, Ramirez D, Hald T: High flow infravesical obstruction in men: symptomatology, urodynamics and the results of surgery. J Urol 1982;127:943-945.
9.
Abrams P, Bruskewitz R, De La Rosetta J: The diagnosis of bladder outlet obstruction; in Cockett ATK, Khoury S, Aso Y, Chatelain C, Griffiths K, Murphy G, Denis L (eds): International Consultation on Benign Prostatic Hyperplasia (3rd, 1995, Monaco). Jersey, Scientific Communication International, 1996, pp 299-367.
10.
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A; Standardisation Sub-committee of the International Continence Society: The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002;21:167-178.
11.
Swinn MJ: Urodynamics; in Fowler CJ (ed): Neurology of Bladder, Bowel, and Sexual Dysfunction: Blue Books of Practical Neurology, Vol 23. Boston, Butterworth-Heinemann Medical, 1999, pp 97-107.
12.
Griffiths D, Höfner K, van Mastrigt R, Rollema HJ, Spångberg A, Gleason D: Standardization of terminology of lower urinary tract function: pressure-flow studies of voiding, urethral resistance, and urethral obstruction. International Continence Society Subcommittee on Standardization of Terminology of Pressure-Flow Studies. Neurourol Urodyn 1997;16:1-18.
13.
Blake C, Abrams P: Noninvasive techniques for the measurement of isovolumetric bladder pressure. J Urol 2004;171:12-19.
14.
Pel JJ, van Mastrigt R: The variable outflow resistance catheter: a new method to measure bladder pressure noninvasively. J Urol 2001;165:647-652.
15.
Drinnan MJ, Pickard RS, Ramsden PD, Griffiths CJ: Assessment of prostatic obstruction: a cuff may be enough. Neurourol Urodyn 2003;22:40-44.
16.
McArdle F, Clarkson B, Robson W, Griffiths C, Drinnan M, Pickard R: Interobserver agreement for noninvasive bladder pressure flow recording with penile cuff. J Urol 2009;182:2397-2403.
17.
Sonke GS, Kortmann BB, Verbeek AL, Kiemeney LA, Debruyne FM, de La Rosette JJ: Variability of pressure-flow studies in men with lower urinary tract symptoms. Neurourol Urodyn 2000;19:637-651; discussion 651-656.
18.
Griffiths DJ: Assessment of detrusor contraction strength or contractility. Neurourol Urodyn 1991;10:1-18.
19.
Gotoh M, Yoshikawa Y, Kondo AS, Kondo A, Ono Y, Ohshima S: Prognostic value of pressure-flow study in surgical treatment of benign prostatic obstruction. World J Urol 1999;17:274-278.
20.
Boettcher S, Brandt AS, Roth S, Mathers MJ, Lazica DA: Urinary retention: benefit of gradual bladder decompression - myth or truth? A randomized controlled trial. Urol Int 2013;91:140-144.
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2014
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