title: Usefulness of an algebraic fitting of nomograms allowing evaluation detrusor contractility in women.
abstract: OBJECTIVE
  Nomograms based on Valentini-Besson-Nelson (VBN) model implying only 3 measurements (filling bladder volume, maximum flow-rate [Qmax] and detrusor pressure at Qmax) were recently developed to evaluate detrusor contractility (k) and urethral obstruction (U) in women. As their algebraic fitting leads to fast evaluations (Excel®software), our aims were applications to populations of non-neurologic women without and with bladder outlet obstruction (BOO).
  
  
  METHODS
  The software was applied to measurements obtained during pressure flow studies. Hidden hypothesis of nomograms were no significant contribution of abdominal pressure between onset of flow and Qmaxand standard nervous excitations until Qmax. Studied populations were 202 women without symptom suggestive of obstruction and 125 women with proven anatomical urethral obstruction who underwent urodynamic study.
  
  
  RESULTS
  For non-obstructed women, a good agreement was found between the values of k and U obtained using nomograms or a complete VBN analysis of the recorded curves. Whatever the obstructive status, there was a good correlation between the value of k and U. Evolution with ageing was similar with higher values of k and U in the BOO group. Curves k(age) and U(age) gave coefficients allowing an age adjustment. The high k value in the detrusor overactive (DO) group was consistent with a similar effect to that of BOO on the detrusor.
  
  
  CONCLUSIONS
  Evaluation of detrusor contractility (k) and urethral obstruction (U) can be obtained from the point of Qmaxduring pressure-flow study. Evolution with ageing is similar with (higher values) or without BOO. DO also induces an increased detrusor contractility.
  
  
  METHODS
  4.
authors.affiliation: Hôpital Rothschild, médecine physique et de réadaptation, 5, rue Santerre, 75012 Paris, France; Université Pierre-et-Marie-Curie, 4, place Jussieu, 75005 Paris, France. Electronic address: francoise.valentini@rth.aphp.fr.
authors.forename: F A
authors.initials: FA
authors.lastname: Valentini
authors.affiliation: Hôpital Saint-Antoine, 75012 Paris, France.
authors.forename: B G
authors.initials: BG
authors.lastname: Marti
authors.affiliation: Hôpital Saint-Antoine, 75012 Paris, France.
authors.forename: P P
authors.initials: PP
authors.lastname: Nelson
authors.affiliation: University of Texas Southwestern, Dallas, TX 75390, USA.
authors.forename: P E
authors.initials: PE
authors.lastname: Zimmern
authors.affiliation: Hôpital Rothschild, médecine physique et de réadaptation, 5, rue Santerre, 75012 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Robain
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D009130:Muscle, Smooth / Q000503:physiopathology*; D049451:Nomograms; D001743:Urinary Bladder / Q000503:physiopathology*; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis*; D014563:Urodynamics / Q000502:physiology*
keywords: Bladder outlet obstruction; Contractilité du detrusor; Detrusor contractility; Femme; Nomogrammes; Nomograms; Obstruction sous-vésicale; Women