[Value of the stop-test in the diagnosis of detrusor hyperactivity. Concept of the isometric zone. Preliminary study of 30 cases].
The authors propose a new pathophysiological and diagnostic approach to detrusor hyperactivity by the study of the isometric pressure obtained during the stop-test. This test consists of the sudden interruption of micturition by voluntary contraction of the striated urethral sphincter, resulting in sudden contraction of the bladder against the closed sphincter. This isometric contraction is equal to 20 to 30 cm of water. The increase in the pressure (delta P) between the basal micturition pressure and the absolute value of the isometric pressure (P iso) reflects the contractile force of the detrusor. The progressive return to the basal micturition pressure reflects the relaxation of the detrusor, which is the sum of visco-elastic properties and the mechanisms of cortico-sub-cortical neurological inhibition. Calculation of the isometric area (delta P X T/2), where T represents the time taken to return to the initial pressure, allows cases of central neurological hyperactivity (isometric area always greater than 100) to be distinguished from cases of detrusor hyperactivity of mechanical origin (isometric area less than 80). These data have been confirmed in a series of 30 patients.
Amarenco
G
G
Service de Neurologie, CHG Robert Ballanger, Aulnay-Sous-Bois.
Savatovsky
I
I
Lacroix
P
P
Perrigot
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006874:Hydrostatic Pressure; D007537:Isometric Contraction; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D009130:Muscle, Smooth / Q000503:physiopathology*; D001745:Urinary Bladder Diseases / Q000175:diagnosis* / Q000503:physiopathology; D014554:Urination
Intérêt du stop-test dans le diagnostic des hyperactivités détrusoriennes. Notion d'aire isométrique. Etude préliminaire de trente cas.