Urodynamics and Clinical Factors That Are Associated With Bladder Over-sensitivity

Overview

Urodynamic examination evaluates storage and empting phases of the urinary bladder. It enables the clinician to correlate physiologic findings to patients' complains. The data gathered during the examination divided to storage and empting. During the storage phase, bladder sensation is measured while the bladder is filled with sterile water. During years of practice, we noticed that early sensation (bladder over-sensitivity) is occasionally associated with bladder outlet obstruction (as demonstrated in the emptying phase of the examination.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: April 1, 2020

Detailed Description

The study includes patients who were referred to Urodynamics examination due to lower urinary tract symptoms. There is no actual intervention during the examination. Though, patients are asked to fill an International prostate symptom score (IPSS-questionnaires).

Interventions

  • Other: IPSS questionnaire
    • IPSS is an 8 question (7 symptom questions + 1 quality of life question) written screening tool used to screen for, rapidly diagnose, track the symptoms of, and suggest management of patients with lower urinary tract symptoms. It was validated for both genders.

Arms, Groups and Cohorts

  • Patients undergoing urodynamic
    • All patients older than 18 who are refered for Urodynamics examination

Clinical Trial Outcome Measures

Primary Measures

  • Early sensation during the filling phase
    • Time Frame: During the urodynamic examination
    • Bladder oversensitivity (early sensation), a diagnosis made by symptoms and urodynamic investigations. Defined as an increased perceived bladder sensation during bladder filling with specific cystometric findings of: (i) an early first desire to void; (ii) an early strong desire to void, which occurs at low bladder volume; (iii) a low maximum cystometric bladder capacity; no abnormal increases in detrusor pressure.

Participating in This Clinical Trial

Inclusion Criteria

  • All patients refered to Asaf HaRofeh Medical Center for Urodynamic examination Exclusion Criteria:

  • Inability to sign an informed concent – Administration of analgesics 8 hours prior to the examination – Known urethral stricture – Chronic bladder or urethral pain – Active cystitis – Permanent urinary catheter

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Assaf-Harofeh Medical Center
  • Provider of Information About this Clinical Study
    • Principal Investigator: Prof. Kobi Stav, Head of the Neuro-Urologic Unit – Assaf-Harofeh Medical Center
  • Overall Official(s)
    • Kobi Stav, MD, Principal Investigator, Assaf-Harofeh Medical Center
  • Overall Contact(s)
    • Guy Verhovsky, MD, 972-8-9779409, guy.verchovsky@gmail.com

References

Campbell Walsh Urology chapter 73

Lee WC, Wu HP, Tai TY, Yu HJ, Chiang PH. Investigation of urodynamic characteristics and bladder sensory function in the early stages of diabetic bladder dysfunction in women with type 2 diabetes. J Urol. 2009 Jan;181(1):198-203. doi: 10.1016/j.juro.2008.09.021. Epub 2008 Nov 14.

Schurch B, Schmid DM, Kaegi K. Value of sensory examination in predicting bladder function in patients with T12-L1 fractures and spinal cord injury. Arch Phys Med Rehabil. 2003 Jan;84(1):83-9. doi: 10.1053/apmr.2003.50007.

El-Zawahry A, Alanee S, Malan-Elzawahry A. The Use of Urodynamics Assessment Before the Surgical Treatment of BPH. Curr Urol Rep. 2016 Oct;17(10):73. doi: 10.1007/s11934-016-0626-y.

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