Elizabeth R Mueller1,2, Heather Litman3, Leslie R Rickey4, Larry Sirls5, Peggy Norton6, Tracey Wilson7, Pamela Moalli8, Michael Albo9, Philippe Zimmern10. 1. Department of Urology, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois. 2. Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois. 3. New England Research Institutes, Watertown, Massachusetts. 4. Department of Urology, University of Maryland, Baltimore, Maryland. 5. Department of Urology, William Beaumont Hospital, Royal Oak, Michigan. 6. Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah. 7. Department of Urology, University of Alabama Medical Center, Birmingham, Alabama. 8. Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, Pennsylvania. 9. Department of Urology, University of California, San Diego, California. 10. Department of Urology, Southwestern Medical Center, Dallas, Texas.
Abstract
AIMS: The Blaivas-Groutz nomogram defines voiding obstruction in women using Qmax from the NIF and the maximum detrusor pressure (Pdetmax ) 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 and voided volume (VV) 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 (Qmax ) for both NIF and PFS. The mean age was 53. Overall, higher VV were observed during PFS compared to NIF and subjects had higher Qmax with NIF compared to PFS. The relationship between Qmax and VV was significantly different between NIF and PFS (P < 0.004). At 200 ml, NIF Qmax was 14% higher than PFS Qmax and this difference increased to 30% at 700 ml. CONCLUSION: The difference between PFS Qmax and NIF Qmax increases as VV 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.
AIMS: The Blaivas-Groutz nomogram defines voiding obstruction in women using Qmax from the NIF and the maximum detrusor pressure (Pdetmax ) 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 and voided volume (VV) 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 (Qmax ) for both NIF and PFS. The mean age was 53. Overall, higher VV were observed during PFS compared to NIF and subjects had higher Qmax with NIF compared to PFS. The relationship between Qmax and VV was significantly different between NIF and PFS (P < 0.004). At 200 ml, NIF Qmax was 14% higher than PFS Qmax and this difference increased to 30% at 700 ml. CONCLUSION: The difference between PFS Qmax and NIF Qmax increases as VV 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.
Authors: Werner Schäfer; Paul Abrams; Limin Liao; Anders Mattiasson; Francesco Pesce; Anders Spangberg; Arthur M Sterling; Norman R Zinner; Philip van Kerrebroeck Journal: Neurourol Urodyn Date: 2002 Impact factor: 2.696
Authors: Paul Abrams; Linda Cardozo; Magnus Fall; Derek Griffiths; Peter Rosier; Ulf Ulmsten; Philip Van Kerrebroeck; Arne Victor; Alan Wein Journal: Urology Date: 2003-01 Impact factor: 2.649
Authors: R C Bump; A Mattiasson; K Bø; L P Brubaker; J O DeLancey; P Klarskov; B L Shull; A R Smith Journal: Am J Obstet Gynecol Date: 1996-07 Impact factor: 8.661
Authors: Elizabeth Mueller; John Wei; Ingrid Nygaard; Linda Brubaker; Ed Varner; Anthony Visco; Geoffrey W Cundiff; Anne M Weber; Chiara Ghetti; Karl Kreder Journal: Neurourol Urodyn Date: 2008 Impact factor: 2.696