title: Comparison of urodynamic volume measurements using room and body temperature saline:  a double-blinded randomized crossover study design.
abstract: BACKGROUND
  Urodynamic studies, routinely performed in women with lower urinary tract symptoms, have a large impact on clinical decision making. Unfortunately, these studies are insensitive in reproducing idiopathic detrusor overactivity (IDO). We set out to examine whether serial cystometry with different distending fluid temperatures could better reproduce symptoms.
  
  
  METHODS
  Eighty-six women were enrolled in a double-blinded, randomized, crossover study. Two cystometries were performed in series, starting with either body temperature fluid (BTF) or room temperature fluid (RTF) and then repeating cystometry with the other temperature fluid. Primary outcomes included first sensation, first urge, and maximum cystometric capacity. Secondary outcomes included subjective sensation of bladder discomfort and the incidence of IDO.
  
  
  RESULTS
  In aggregate, the temperature of the fluid did not affect volumes of bladder sensation. There were no differences in self-reported bladder irritation or IDO between the different temperature fluids. There was a significant carryover effect with BTF. BTF administered first reached sensory thresholds at lower volumes than when it was administered second after RTF. Room temperature fluid cystometry showed no statistical difference in volume between first fill and second fill. Idiopathic detrusor overactivity contractions were seen in 9% of studies and were not affected by period or temperature.
  
  
  CONCLUSIONS
  These data suggest that BTF and RTF independently do not affect bladder sensory thresholds. The periodicity in combination with varying fluid temperature is of greater impact. This study documents that changes in temperature of the distending fluid from BTF to RTF or vice versa likely do not provoke IDO contractions.
authors.affiliation: Tripler Army Medical Center, Honolulu, HI 96859-5000, USA. alan.gehrich@us.army.mil
authors.forename: Alan Paul
authors.initials: AP
authors.lastname: Gehrich
authors.forename: Micah J
authors.initials: MJ
authors.lastname: Hill
authors.forename: Grant D E
authors.initials: GD
authors.lastname: McWilliams
authors.forename: Wilma
authors.initials: W
authors.lastname: Larsen
authors.forename: Tamarin
authors.initials: T
authors.lastname: McCartin
mesh_terms: D000328:Adult; D001831:Body Temperature; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D012684:Sensory Thresholds; D012965:Sodium Chloride; D013696:Temperature; D001743:Urinary Bladder / Q000502:physiology; D053201:Urinary Bladder, Overactive / Q000503:physiopathology; D014563:Urodynamics
chemical_list: D012965:Sodium Chloride