title: Detrusor pressures in urodynamic studies during voiding in women.
abstract: OBJECTIVE
  To investigate detrusor pressure during voiding in women using urodynamic studies (UDS).
  
  
  METHODS
  The study group comprised 57 women with non-neurogenic lower urinary tract symptoms. All patients underwent UDS between January 2010 and December 2014. UDS included filling cystometry, pressure flow study (PFS), uroflowmetry for the maximum flow rate (Qmax) and mean flow rate, and postvoid residuals. Existence of voluntary detrusor contraction was defined as a continuous and smooth increase in detrusor pressure (Pdet) after the instruction to micturate in the PFS. The bladder contractility index (BCI) was calculated as Pdet at Qmax + 5 × Qmax. Statistical analyses were performed using the Mann-Whitney U test and p < 0.05 was considered statistically significant.
  
  
  RESULTS
  The PFS showed that 23 patients had detrusor contraction (Pdet+ group) and 34 patients had no detrusor contraction (Pdet- group) during voiding. There were no significant differences in urodynamic parameters between the Pdet+ and Pdet- groups except in Pdet at Qmax and BCI. In the Pdet- group, 21 patients showed an increase in abdominal pressure during voiding (Pabd+ group), while the other 13 patients did not (Pabd- group). There were no differences in any of the urodynamic parameters between the Pabd+ and Pabd- groups.
  
  
  CONCLUSIONS
  Based on UDS, an increase in detrusor or abdominal pressure may not be necessary in micturition in women. The present study suggests that relaxation of pelvic floor muscles including normal urethral function are important for micturition in women.
authors.affiliation: Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan. skira@yamanashi.ac.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Kira
authors.affiliation: Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Mitsui
authors.affiliation: Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Yaburu
authors.initials: Y
authors.lastname: Haneda
authors.affiliation: Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Norifumi
authors.initials: N
authors.lastname: Sawada
authors.affiliation: Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Shimokato 1110, Chuo, Yamanashi, 409-3898, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology*; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D011312:Pressure; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014521:Urethra / Q000502:physiology*; D014554:Urination / Q000502:physiology*; D014563:Urodynamics
keywords: Contractility; Detrusor; Female; Micturition; Underactivity; Urodynamics