title: Can We State Stable Bladder? How Many Repetitions Should We Do for an Appropriate Demonstration of Involuntary Detrusor Contraction?
abstract: OBJECTIVE
  Involuntary Detrusor Contraction (IDC) may alter therapeutic plans; therefore, urodynamic demonstration (UD) is pivotal. We explore if same session repetitions enhance its demonstration and minimize false-negative results.
  
  
  METHODS
  Two hundred fifty two women (mean age 47 ± 5.7) had 4 full repetitions of UD with the last round filled with 4°C fluid (Ice-water test). IDC was diagnosed if with at least 3 cm H2O after artifacts were ruled out.
  
  
  RESULTS
  44.4% of the cases showed IDC in the first round of the exam but it could be demonstrated in 88.5% of the women if 4 rounds are taken into account. Only 2 cases showed IDC exclusively in the first round. Nine cases (3.5%) showed IDC in the first round and only on Ice-test, while all other IDC-detected cases revealed it in scattered patterns along the repetitions. Likewise, IDC detection on the second, third and fourth rounds varied widely and unpredictably, many failing to show a consistent pattern of presentation after its detection. IDC wave amplitude did not show any correlation to the detection.
  
  
  CONCLUSIONS
  Urodynamic repetition is a necessary procedure where IDC is important to demonstrate, as its false-negative rate is high and its unpredictable pattern of detection may be improved by repetition.
authors: Urology Clinic, Hospital Beneficência Portuguesa of São Paulo, São Paulo, Brazil.
authors: Paulo
authors: P
authors: Rodrigues
authors: Flávio
authors: F
authors: Hering
authors: Eli
authors: E
authors: Cieli
authors: Marcio
authors: M
authors: D'Imperio
authors: João Carlos
authors: JC
authors: Campagnari
mesh_terms: D000328:Adult; D000368:Aged; D016477:Artifacts; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D009122:Muscle Hypertonia / Q000503:physiopathology; D009130:Muscle, Smooth / Q000473:pathology; D056887:Pelvic Organ Prolapse / Q000601:surgery; D011446:Prospective Studies; D012008:Recurrence; D015203:Reproducibility of Results; D013696:Temperature; D001743:Urinary Bladder / Q000473:pathology*; D053201:Urinary Bladder, Overactive / Q000175:diagnosis*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis*; D014552:Urinary Tract Infections / Q000601:surgery; D014555:Urination Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D014563:Urodynamics