Presentation Authors: Françoise Valentini, Brigitte Marti, Gilberte Robain, Paris, France, Philippe Zimmern*, Dallas, TX, Pierre Nelson, Paris, France
Introduction: Bladder voiding efficiency (BVE) is measured according to the degree of bladder emptying and defined as the ratio between voided volume and total bladder capacity . This simple index, easy to calculate, is not widely used. Aims of the study were first to evaluate the reproducibility of BVE between free flow (FF) and intubated flow (IF) and second to search for a relationship between BVE and urodynamic diagnosis (UD) in women.
Methods: Urodynamic tracings of non-neurological women referred for investigation of various lower urinary tract symptoms were analyzed. Urodynamic study included one FF followed by one cystometry (urethral catheter 7F). Post void residual volume (PVR) was measured using a Bladder-scan. Exclusion criteria were voided volume < 100 mL and prolapse of grade >2.
Results: Of 375 urodynamic studies, 237 women met study criteria. Mean age was 58Â±15 years. Main complaint was stress urinary incontinence (52), urge incontinence (65), mixed incontinence (71), frequency (22), dysuria (9) and other (urinary tract infection, interstitial cystitis, pain (18)). Overall BVE IF (82.6Â±25.3) was significantly lower than BVE FF (91.7Â±14.7) (p < .0001).After urodynamic study, urodynamic diagnosis was posed according to the ICS/IUGA recommendations and 2 sub-groups defined according with involvement of detrusor. The first (135 women) had UD related to detrusor dysfunction (bladder outlet obstruction, detrusor hyperactivity with impaired contractility, detrusor overactivity, detrusor underactivity). The second (102 women) had UD found â€œnormalâ€ (N), related to urethral dysfunction (U) (intrinsic sphincter deficiency or showing voiding triggered by urethral relaxation). No significant difference in BVE FF between the 2 sub-groups while BVE IF differed significantly (p=.0002), BVE IF only significantly lower than BVE FF (p < .0001) in case of detrusor dysfunction (table).
Conclusions: In this large cohort of non-neurogenical women studied urodynamically for a variety of LUTS, there is no correlation between BVE measured from a FF and BVE obtained during an IF. But, for a given patient, when a difference in BVE is observed between FF and IF, there seems that BVE is a good indicator of voiding dysfunction related to detrusor disturbance. 1-BJUInt 1999;84:14-5