• Physiological measurement
• continence technology
• diagnostic instrumentation
• diagnostic monitoring
• research

• Humans
• Urinary Incontinence/physiopathology
• Research
• Urodynamics

• air-filled catheter
• initial abdominal pressure
• initial intravesical pressure
• initial resting intravesical pressure
• obesity-related measurements

• Humans
• Catheters
• Urodynamics
• Prospective Studies
• Body Mass Index
• Obesity/complications

• 81770673 National Natural Science Fund of China

• abdominal compartment syndrome
• air-filled catheter
• balloon-in-balloon design
• continuous measurement
• intra-abdominal hypertension
• intra-abdominal pressure
• supine position

• Humans
• Animals
• Swine
• Intra-Abdominal Hypertension/diagnosis
• Critical Illness
• Catheters

• Aging
• Childbirth
• Female hormones
• Pregnancy
• Urethral function
• Woman’s lifetime

• Pregnancy
• Female
• Humans
• Urethra
• Urinary Incontinence, Stress/etiology
• Cross-Sectional Studies
• Urinary Bladder
• Urodynamics
• Estrogens

• air-filled
• pressure management
• urodynamics
• water-filled

To compare in vivo differences of two catheter systems for urodynamics to further discover their measurement properties.

Side‐by‐side catheterization with two catheters for intravesical and abdominal pressure during full cystometry in 36 prospectively recruited patients with analysis of mean and absolute differences at urodynamic events and post hoc in‐depth signal analysis comparing the full pressure traces of both systems.

The mean pressure differences at urodynamic events between air‐filled and water‐filled systems are small, however, with a large variation, without a systematic difference. The majority of the intersystem differences are significantly larger than 5 cmH₂O. Further analysis showed that urodynamic event pressure differences of both systems at the start of the test were carried forward throughout the remainder of the test without subsequent or additional tendency to differ. Post hoc whole test signal analysis with pressures equalized from the first sample shows high cross‐correlation (>0.981) between the pressure signals per location (rectum and bladder) per test and almost zero‐time shift (<0.05 s) of all cystometry pressure samples.

We confirm earlier studies that showed random differences at events between air‐filled and water‐filled pressures during clinical urodynamic testing and confirm that these are intrinsic but not systematic—and still incompletely explained—offset‐baseline differences. We determined on closer full measurement analysis after equalizing, that both systems are similar in displaying urodynamic pressure variations and amplitudes. We also confirm that both systems require awareness of intrinsic measurement properties during urodynamic testing and especially may necessitate adjustment of pressure offsets into a quantitative diagnosis of a urodynamic test.

• T-DOC
• air-charged catheter
• pediatrics
• urodynamics

Urodynamics is the study of the storage and evacuation of urine from the urinary tract. The aim is to reproduce the patient’s symptoms and provide a pathophysiological explanation for them by identifying all factors that contribute to the lower urinary tract dysfunction, including those that are asymptomatic. Urodynamics consists of various tests, each of which is designed to assess a different aspect of lower urinary tract function. There is a lack of evidence regarding when urodynamics should be used in the non-neurogenic bladder. Some small randomised controlled trials suggest that urodynamics does not alter the outcome of surgery for stress urinary incontinence when compared with office evaluation alone. However, this is widely felt to be inaccurate and many health-care professionals still advocate the use of urodynamics prior to any invasive treatment, especially surgery on the lower urinary tract. There have been few technological advances in urodynamics in recent years. Air-charged rather than fluid-filled catheters were thought to help reduce artefact, but the evidence is unclear, and there is doubt over their accuracy. Ambulatory urodynamics is carried out over a longer period of time, enabling physiological bladder filling, but it remains invasive and artificial. To attempt to replicate symptoms more accurately, there have been efforts to develop wireless devices to measure detrusor pressure directly. These may be promising but are far from suitable in humans at present. Urodynamics continues to provide useful information for assessing lower urinary tract function, but further large studies are required to assess its value and develop innovations to improve the accuracy of the tests and acceptability to patients.

• Advances
• Urodynamics

• quality
• research needs
• training
• urodynamic studies

Artificial urethral sphincter (AUS) implantation is currently the gold standard for treating moderate and severe urinary incontinence. Currently, cuffs are chosen based on the surgeon’s experience, and adjusting cuff tightness is crucial. The T-DOC air-charged catheter has not been proven to be inferior to traditional catheters. We report how intraoperative urethral pressure profilometry is performed using a T-DOC air-charged catheter with ambulatory urodynamic equipment, to guide cuff selection and adjustment.

A 67-year-old man presented to our hospital with complete urinary incontinence following transurethral prostatectomy, using five pads/d to maintain local dryness. Preoperatively, the maximum urethral pressure (MUP) and maximum urethral closure pressure (MUCP) were 52 cmH2O and 17 cmH2O, respectively. An AUS was implanted. Intraoperatively, in the inactivated state, the MUP and MUCP were 53 cmH2O and 50 cmH2O, respectively; in the activated state, they were 112 cmH2O and 109 cmH2O, respectively. The pump was activated 6 wk postoperatively. Re-measurement of the urethral pressure on the same day showed that in the inactivated state, MUP and MUCP were 89 cmH2O and 51 cmH2O, respectively, and in the activated state, 120 cmH2O and 92 cmH2O, respectively. One month after device activation, telephonic follow-up revealed that pad use had decreased from five pads/d to one pad/d, which met the standard for social continence (0-1 pad per day). There were no complications.

The relationship between intraoperative urethral pressure and urinary continence post-surgery can provide data for standardizing AUS implantation and evaluating efficacy.

• Urethral pressure profilometry
• Urinary sphincter, Artificial
• Maximum urethral pressure
• Maximum urethral closure pressure
• Urinary incontinence
• Case report

• catheterization
• functional urethral length
• maximum urethral closure pressure
• urethral

• Air-filled catheter
• Comparison study
• Urodynamics
• Water-filled catheter

• incontinence
• leak point pressure
• quality of life
• stress
• urethral pressure profile