title: Qualitative quality control during urodynamic studies with TSPs for cystometry in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia.
abstract: The aim of this study was to describe typical signal patterns (TSPs) by amplitude and pressure gradients and indicate the role and significance of them in quality control. A total of 582 measurements from a multicenter urodynamic study on males (mean age, 65.3 years) were re-analyzed. Using manual graphical analysis, we identified signal patterns by typical amplitude (A) and typical pressure gradient (PG). TSPs were classified into four types: I: fine structure (A < 3 cm H2O); II: minor dynamic changes (A < 5 cm H2O); III: major changes due to cough tests (A > 50 cm H2O, PG > 100 cm H2O/s); IV: typical major changes due to muscular activity: detrusor overactivity (A > 3 cm H2O, PG > 1-5 cm H2O/s), rectal contractions (A = 5-10 cm H2O, PG = 5-10 cm H2O/s), and straining (A > 5 cm H2O, PG ≥ 30 cm H2O/s). At beginning of and during filling, 91.8 and 98.3 % of traces showed the identical fine structure and minor changes between P ves and P abd tracings, and P det tracing was quiet. 92.3 % of P ves and P abd traces had equal pressure changes at test coughs. During filling, 8.3 % traces showed straining, 17.4 % showed rectal contractions, and 33.7 % showed detrusor overactivity. Before voiding, 94 % of P ves and P abd traces had equal cough response. During voiding, 91.2 % of traces showed the same fine structure, 53.3 % of traces showed straining, and 15.3 % showed relaxation of the pelvic floor. After voiding, 91.2 % of traces had the same fine structure, and 87.5 % had an equal cough response. TSPs are a powerful tool for qualitative plausibility and quality control and are an indispensable pre-condition for good urodynamic practice.
authors.affiliation: Department of Urology, China Rehabilitation Research Center, Capital Medical University, 100068, Beijing, China, lmliao@263.net.
authors.forename: Limin
authors.initials: L
authors.lastname: Liao
authors.forename: Werner
authors.initials: W
authors.lastname: Schaefer
mesh_terms: D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology; D011312:Pressure; D011470:Prostatic Hyperplasia / Q000150:complications*; D011786:Quality Control; D001743:Urinary Bladder / Q000503:physiopathology*; D053201:Urinary Bladder, Overactive / Q000503:physiopathology; D014554:Urination / Q000502:physiology; D014563:Urodynamics