conventional urodynamics, where the variable PC1 proved clinically discerning ... (1) Conventional and extramural ambulatory urodynamic testing of the lower.
Abstracts conventional
urodynamics,
where
the
variable
PC1
proved
clinically
discerning and not PC2.
REFERENCES ( 1 ) Conventional and extramural ambulatory urodynamic testing o f the lower
urinary tract i n female volunteers, J Urol 1992,147(5):1319-1325. (2) A data reduction
technique
f o r describing and qualifying detrusor
instability, Int Urogynecol J 1993,4:204-211.
81
K. Heslinaton, P. Hilton.
Department of Gynaecology, RVI, Newcastle upon Tyne. NE1 4LP. England.
A COMPARISON OF AMBULATORY MONITORING AND CONVENTIONAL CYSTOMETRY IN ASYMPTOMATIC FEMALE VOLUNTEERS. KM& Ambulatory monitoring continues to gain acceptance and increasing clinical application but there remains a sparsity of published data from asymptomatic volunteers, particularly female volunteers. The aim was to determine normal values for variables of filling and voiding cystometry, and the incidence of unstable detrusor contractions in asymptomatic women based on ambulatory monitoring.
PATIENTS AND METHODS. Thirteen women (median age 4 2 (range 29-77)) free from urinary symptoms were recruited from staff and gynaecological in-patients. A standard questionnaire of urinary complaints was administered and any patients with significant symptoms excluded. Conventional cystometry and ambulatory monitoring (median duration 175 min (range 120-259)) was undertaken in all volunteers in random order. Volunteers were asked to go about everyday activities and to keep a detailed diary whilst undergoing ambulatory monitoring. The incidence of spontaneous or provoked detrusor contractions was noted and their amplitude. Although the International Continence Society does not classify uninhibited detrusor contractions by magnitude it was felt that arbitrary cut-off levels facilitated interpretation of the ambulatory monitoring traces. It was difficult to identify contractions 15cmH20 to be ihdicative of detrusor instability. Any association of detrusor contractions with patient symptoms was also noted. Other parameters studied were detrusor pressure tise at capacity, the incidence of aftercontractions, voided volumes, voiding pressures and urine flow rates. Flow rate data was not available on ambulatory monitoring at the time of study.
RESULTS. The incidence of detrusor contractions is shown below in Table 1.
Abstracts
534 Table 1.
Inai&na
of
detrumor aontrrotionm.
Detrusor activlty IcmHZOI
CMG
< 5
9
5-15 >15
AM
: ,0’1
F,
(?A+\
3 (23+)
4 (31*)
:
4
; ;*,
(31U)
3ne subject showed evidence of detrusor instability on conventional cystometry and on ambulatory monitoring.
A
total of 4 subjects showed evidence of detrusor
instability on ambulatory monitoring. This increased detrusor activity on ambulatory monitoring was consistently demonstrated in each voiding cycle in 1 of the sublects and associated with urinary symptoms in 3 of the subjects. On conventional cystometry, data concerning aftercontractions was not available as in 8 of the subjects the fluid filled lines became dislodged during voiding. In the remaining 5 subjects no aftercontractions were apparent. However, in 7 of the 13 sublects on ambulatory monitoring, aftercontractions appeared to be present following one or more void. Subjective assessment from the symptom diaries suggested that 3 subjects had what they termed moderate discomfort on conventional cystometry and 4 subjects reported moderate discomfort on ambulatory monitoring. Significant differwces were found between ambulatory monitoring and conventional cystometry with respect to the pressure rise on filling (p
