The Value of Urethral Pressure Profile Using Air-Charged Catheters in the Diagnosis of Female Bladder Neck Obstruction

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

LUTS: Lower Urinary Tract Symptoms Pub Date : 2025-04-28 DOI:10.1111/luts.70013

Yan Qin, Fei Wang, Chaohua Zhang, Liyang Wu

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引用次数: 0

Abstract

Objectives

Rarely have studies focused on the utilization of urethral pressure profile (UPP) in bladder neck obstruction (BNO). This study aimed to evaluate the parameters of UPP in urodynamic testing (UDS) using air-charged catheters (ACC) and to investigate the value of UPP as a diagnostic tool for female BNO.

Patients and Methods

We retrospectively collected records of 165 female patients with lower urinary tract symptoms (LUTS) who received UDS at our center from September 2020 to September 2022. The whole patient group was divided into BNO group (n = 92) and non-BNO group (n = 73). The urodynamic data were evaluated.

Results

The UPP includes urethral pressures at the bladder neck (b-UP) and urethral sphincter (s-UP). The b-UP was higher in the BNO group than in the non-BNO group [104.50 (40.50) cmH2O vs. 58.00 (33.50) cmH2O, p < 0.001]. According to multivariable logistic regression analysis, b-UP and bladder voiding efficiency (BVE) were independently associated with BNO. The area under the curve (AUC) of the b-UP had the best value for predicting BNO [AUC: 0.878, sensitivity: 88.04%, specificity: 76.71%, 95% confidence interval (CI): 0.819–0.924]; its cut-off value was 72 cmH2O. Meanwhile, Cohen's kappa was 0.65 (95% CI: 0.537–0.770), indicating that UPP as a diagnostic tool was highly consistent with the video-urodynamic study (VUDS).

Conclusions

UPP by air-charged urodynamic catheters can show the pressure of the bladder neck, with predictive value for identifying BNO in women. The predictive method based on UPP and pressure-flow study (PFS) without fluoroscopy will improve the diagnostic accuracy of BNO, which could help urologists in making better clinical decisions.

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充气导尿管尿道压力谱在女性膀胱颈梗阻诊断中的价值

目的尿道压力谱（UPP）在膀胱颈梗阻（BNO）诊断中的应用研究很少。本研究旨在评价充气导尿管尿动力学试验（UDS）中UPP的参数，并探讨UPP作为女性BNO诊断工具的价值。患者和方法回顾性收集2020年9月至2022年9月在我中心接受UDS治疗的165例有下尿路症状（LUTS）的女性患者的记录。整个患者组分为BNO组（n = 92）和非BNO组（n = 73）。评估尿动力学数据。结果UPP包括膀胱颈（b-UP）和尿道括约肌（up）处的尿道压力。BNO组的b-UP高于非BNO组[104.50 (40.50)cmH2O比58.00 (33.50)cmH2O, p < 0.001]。经多变量logistic回归分析，b-UP和膀胱排尿效率（BVE）与BNO独立相关。b-UP曲线下面积（AUC）对BNO的预测价值最佳[AUC: 0.878，敏感性：88.04%，特异性：76.71%，95%可信区间（CI）： 0.819-0.924]；其临界值为72 cmH2O。同时，Cohen’s kappa为0.65 (95% CI: 0.537-0.770)，表明UPP作为诊断工具与视频尿动力学研究（VUDS）高度一致。结论充气尿动力导尿管UPP可显示膀胱颈压力，对诊断女性BNO有预测价值。基于UPP和压力流量研究（PFS）的无透视预测方法将提高BNO的诊断准确性，有助于泌尿科医生更好地做出临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

LUTS: Lower Urinary Tract Symptoms UROLOGY & NEPHROLOGY-

CiteScore

3.00

自引率

7.70%

发文量

审稿时长

>12 weeks

期刊介绍： LUTS is designed for the timely communication of peer-reviewed studies which provides new clinical and basic science information to physicians and researchers in the field of neurourology, urodynamics and urogynecology. Contributions are reviewed and selected by a group of distinguished referees from around the world, some of whom constitute the journal''s Editorial Board. The journal covers both basic and clinical research on lower urinary tract dysfunctions (LUTD), such as overactive bladder (OAB), detrusor underactivity, benign prostatic hyperplasia (BPH), bladder outlet obstruction (BOO), urinary incontinence, pelvic organ prolapse (POP), painful bladder syndrome (PBS), as well as on other relevant conditions. Case reports are published only if new findings are provided. LUTS is an official journal of the Japanese Continence Society, the Korean Continence Society, and the Taiwanese Continence Society. Submission of papers from all countries are welcome. LUTS has been accepted into Science Citation Index Expanded (SCIE) with a 2011 Impact Factor.