URODYNAMIC ASSESSMENT OF BLADDER INSTABILITY (INCONTINENCE).
Contributors: University of Florida.
Published: 1990
Number of pages: 110
Subjects: Health Sciences, Nursing.; Health Sciences, Medicine and Surgery.
Description: The purpose of this study was to determine the urodynamic variables that aid in the diagnosis of bladder instability and distinguish normal from unstable function in a group of adult women. Six urodynamic variables, (a) number of contractions, (b) maximum contraction pressure, (c) subject report of urgency, (d) occurrence of leakage, (e) presence of sphincter electromyographic quieting and (f) cystometric capacity, were measured over four consecutive fills in which position and fill rate were varied. It was hypothesized that one or more of these factors would discriminate normal from unstable bladder function assessed by urodynamic testing.

Sixty women volunteered for participation in the investigation. Thirty subjects reported normal voiding habits including diurnal frequency greater than every 2 hours, nocturia no more than once per night and absent symptoms of urgency or incontinence. Thirty additional subjects were included who had (a) urinary frequency greater than every two hours, (b) urgency or absent sensations of bladder filling, (c) urge or reflex incontinence, and (d) nocturia more frequently than once per night or nocturnal leakage.

A discriminant function analysis was completed using the urodynamic variables (a) presence of contractions and (b) maximum pressure greater than 15cm H$\sb2$O. Subsequent analyses using six urodynamic variables were completed.

Reliance on urodynamic variables (a) presence of contraction and (b) maximum pressure of 15cm H$\sb2$O limited the accuracy of diagnosis among test subjects. Using the criterion presence of contraction with maximum pressure greater than 15cm H$\sb2$O, the classification accuracy among subjects tested was 73.3%. In contrast, discriminant function analysis using six urodynamic variables for diagnosis of instability demonstrated a classification accuracy rate of 90.5%. Two variables (a) occurrence of leakage with contraction and (b) compromised cystometric capacity emerged as statistically significant for discriminating normal detrusor response to filling from instability. The results provide a clearer understanding of detrusor response during filling cystometrogram necessary for accurate diagnoses and management of bladder instability.
Notes: Source: Dissertation Abstracts International, Volume: 52-03, Section: B, page: 1351.

Thesis (PH.D.)--UNIVERSITY OF FLORIDA, 1990.

School code: 0070.