Phillip P Smith1, Francoise Valentini2, Konstantinos-Vaios Mytilekas3, Apostolos Apostolidis3, Kevin Rademakers4, Linda Cardozo5, Andrew Gammie6. 1. Department of Surgery, University of Connecticut School of Medicine, Farmington, Connecticut. 2. Service de Médecine Physique et de la Réadaptation, Hôpital Rothschild, Université Pierre-et-Marie-Curie, Paris, France. 3. 2nd Department of Urology, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. 4. Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands. 5. Department of Urogynaecology, King's College Hospital, London, UK. 6. Bristol Urological Institute, Southmead Hospital, Bristol, UK.
Abstract
INTRODUCTION: Widely accepted consensus terminology and calculations of detrusor contractility in females do not exist but may be useful. We report the output of a proposal session at the International Consultation on Incontinence Research Society meeting 2019, addressing the title topic. METHODS: Three formal presentations and a lively discussion addressed several questions including: which is the optimal cutoff value of female bladder voiding efficiency during uroflow to suspect obstruction or detrusor underactivity? Is there a definition of pure underactive and pure obstructed voiding in females? Is there a place to distinguish those relatively obstructed from those relatively underactive females especially in those cases of equivocal obstruction? Current measures of contractility were reviewed for their usefulness in women. RESULTS: No recommendation for a specific index or calculation can be made based on current knowledge. "Contractility" may be context-dependent regarding clinical care, clinical prognostication, and physiologic research. CONCLUSIONS: This group proposes that context-sensitive definitions of "Contractility" deserve attention by international leadership. Cooperative clinical and physiologic expertise will be needed to achieve this goal. Following initial recommendations based on expert opinion, the development of final definitions and measures of contractility should be iterative, based upon validation studies to be considered as part of the definitional process.
INTRODUCTION: Widely accepted consensus terminology and calculations of detrusor contractility in females do not exist but may be useful. We report the output of a proposal session at the International Consultation on Incontinence Research Society meeting 2019, addressing the title topic. METHODS: Three formal presentations and a lively discussion addressed several questions including: which is the optimal cutoff value of female bladder voiding efficiency during uroflow to suspect obstruction or detrusor underactivity? Is there a definition of pure underactive and pure obstructed voiding in females? Is there a place to distinguish those relatively obstructed from those relatively underactive females especially in those cases of equivocal obstruction? Current measures of contractility were reviewed for their usefulness in women. RESULTS: No recommendation for a specific index or calculation can be made based on current knowledge. "Contractility" may be context-dependent regarding clinical care, clinical prognostication, and physiologic research. CONCLUSIONS: This group proposes that context-sensitive definitions of "Contractility" deserve attention by international leadership. Cooperative clinical and physiologic expertise will be needed to achieve this goal. Following initial recommendations based on expert opinion, the development of final definitions and measures of contractility should be iterative, based upon validation studies to be considered as part of the definitional process.
Authors: Juan Pablo Valdevenito; Alejandro Mercado-Campero; Luis López-Fando; Carlos Ignacio Calvo; Valentín Manríquez; Loreto Medina Journal: Int Urogynecol J Date: 2022-04-20 Impact factor: 1.932