title: Perugia urodynamic method of analysis (PUMA): a new advanced method of urodynamic analysis applied clinically and compared with other advanced methods.
abstract: OBJECTIVE
  The aim of this study is to compare PUMA curves with different pathologic conditions causing bladder dysfunction in 158 men and 83 women.
  
  
  METHODS
  PUMA results in terms of bladder outlet obstruction and detrusor contractility were compared in 92 men with benign prostatic hypertrophy (BPH) and p(ves) congruent with p(det) (i.e., p(abd) congruent with 0) with the results of the urodynamics operator's opinion, the provisional International Continence Society method, Abrams and Griffith's diagram, urethral resistence factor (URA), Schäfer's diagram, and Watt factor. PUMA curves correlated reliably with different pathologic conditions such as obstructive BPH, orthotopic bladder, cystocele, the neurological bladder, and bladder diverticulum. Statistical analysis indicated excellent agreement between PUMA and URA; agreement with other methods was good in cases of obstruction and nonobstruction. In doubtful cases, as diagnosed by standard methods, PUMA agreed only with the Abrams and Griffith's diagram. PUMA and Wmax were in good agreement on detrusor con traction force. Agreement between PUMA and Schäfer's diagram was excellent for patients with detrusor hypercontractility and good for patients with detrusor hypocontractility and normocontractility. PUMA is the only method applicable to women. It is easy to perform. When integrated with other diagnostic tests, it provides realistic data for diagnosis, medical or surgical therapy, and outcome.
authors.affiliation: Department of Urology, University of Perugia, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Porena
authors.forename: Sauro
authors.initials: S
authors.lastname: Biscotto
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Costantini
authors.forename: Ettore
authors.initials: E
authors.lastname: Mearini
authors.forename: Livio
authors.initials: L
authors.lastname: Verdini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004240:Diverticulum / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009119:Muscle Contraction; D009122:Muscle Hypertonia / Q000175:diagnosis* / Q000503:physiopathology*; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis* / Q000503:physiopathology*; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000503:physiopathology; D014555:Urination Disorders / Q000175:diagnosis / Q000503:physiopathology; D014563:Urodynamics