title: Use of near infrared spectroscopy as an alternative to videourodynamics to detect detrusor overactivity in women with the overactive bladder syndrome.
abstract: OBJECTIVE
  To evaluate near infrared spectroscopy as a noninvasive alternative to cystometry for detecting detrusor overactivity in women with overactive bladder (OAB). Although cystometry is considered the "gold standard" investigation for the lower urinary tract, it is invasive. Recently, a noninvasive form of assessment of the lower urinary tract has been introduced using near infrared spectroscopy.
  
  
  METHODS
  This was a prospective pilot study. Women with symptoms of OAB, referred to a tertiary referral one-stop urodynamics clinic were studied. A urodynamic diagnosis was made according to the International Continence Society guidelines. The near infrared spectroscopy monitoring results were analyzed by an independent near infrared spectroscopy Clinical Research Assessor. Both the urodynamics and near infrared spectroscopy assessors reported whether detrusor overactivity was present. Primary outcome measurement was the performance of near infrared spectroscopy as a new diagnostic test. We evaluated the performance of this by calculating the sensitivity and specificity. The clinical usefulness of near infrared spectroscopy was evaluated using positive and negative predictive values.
  
  
  RESULTS
  One hundred patients were recruited of whom 95 had traces that could be interpreted. Thirty-one patients were found to have detrusor overactivity on cystometry. Twenty-five of these patients (26%) had detrusor overactivity on near infrared spectroscopy analysis. In 6% of these cases, no near infrared spectroscopy changes identified as suggestive of detrusor overactivity were seen. No detrusor overactivity was detected by cystometry in 64 patients, and in 19% of cases by near infrared spectroscopy. Forty-six patients (48%) had near infrared spectroscopy monitoring events identified as detrusor overactivity but no cystometry changes diagnostic of detrusor overactivity.
  
  
  CONCLUSIONS
  The results of our study suggest that near infrared spectroscopy is an unreliable method for detecting detrusor overactivity in women with OAB symptoms.
authors: King's College Hospital NHS Foundation Trust, London, UK. heleni.mastoroudes@nhs.net
authors: Heleni
authors: H
authors: Mastoroudes
authors: Ilias
authors: I
authors: Giarenis
authors: Maria
authors: M
authors: Vella
authors: Sushma
authors: S
authors: Srikrishna
authors: Dudley
authors: D
authors: Robinson
authors: Linda
authors: L
authors: Cardozo
authors: Irene
authors: I
authors: Karrouze
authors: Adele
authors: A
authors: Campbell
authors: A
authors: A
authors: Macnab
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared; D013577:Syndrome; D053201:Urinary Bladder, Overactive / Q000175:diagnosis* / Q000503:physiopathology*; D014563:Urodynamics; D014741:Video Recording; D055815:Young Adult