Continuous occlusion test to determine detrusor contractile performance.
OBJECTIVE
A study was conducted to determine the merits of the continuous occlusion test as a method of detrusor contractility assessment by comparing it with other stop tests and with contractility derived from pressure-flow analysis.


METHODS
The continuous occlusion test was performed in elderly men by occluding the bladder outlet before the onset of a detrusor contraction and it was repeated to assess reproducibility. The magnitude of the isovolumetric contraction, maximum slope of the detrusor contraction, and duration of detrusor activation were determined. Voluntary and mechanical stop tests were performed during the mid voiding phase. Continuous occlusion test parameters were compared with the pressure-flow contractility parameters.


RESULTS
The continuous occlusion test was evaluated in 159 patients. The maximum isovolumetric contraction pressure of the continuous occlusion test was significantly higher than that of the voluntary stop test (49 patients). Continuous occlusion test contractility parameters were reproducible. The maximum isovolumetric contraction pressure and the maximum slope of the detrusor contraction of the continuous occlusion test significantly correlated with the estimated maximum isovolumetric contraction pressure and estimated velocity of shortening (derived from pressure-flow), respectively (r = 0.79, p < 0.0001 and r = 0.385, p = 0.016, 39 patients). The watts factor was well correlated with maximum isovolumetric contraction pressure (r = 0.75, 39 patients).


CONCLUSIONS
Our study suggests that the continuous occlusion test can be used as an effective alternative method of assessing detrusor contractility.
Sullivan
M P
MP
Division of Urology, Brockton/West Roxbury Veterans Affairs Medical Center, Boston, Massachusetts, USA.
DuBeau
C E
CE
Resnick
N M
NM
Cravalho
E G
EG
Yalla
S V
SV
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000503:physiopathology*; D011470:Prostatic Hyperplasia / Q000503:physiopathology*; D015203:Reproducibility of Results; D001743:Urinary Bladder / Q000503:physiopathology*; D014563:Urodynamics