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Invasive Diagnostic Tests

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Underactive Bladder

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Abstract

Cystometry forms the mainstay of invasive DU investigation. No one method has established itself universally as the preferred modality to diagnose DU. In this chapter we discuss the parameters which have been used with their benefits and limitations. The detrusor contraction strength is calculated by subtracting 2X Qmax from the Pdet@Qmax. The limitations with this approach is that the contraction strength cannot be isolated from the outflow resistance and a good flow may simply be due to poor outlet resistance. Similarly, the Watts factor which calculates the power per area of bladder surface is dependent on the grade of bladder outlet obstruction and cannot give an independent cut off value for DUA diagnosis.

The bladder contractility index calculates detrusor strength but needs adjusting for different populations. Occlusion tests can assess detrusor contraction independent of the flow but can be painful and are un-physiological. Other parameters discussed in this chapter include detrusor contraction speed and duration. Ultimately, due to individual limitations with each test no one test has shown dominance. It is for the expert clinician to take a good history and assess this with a suitable test(s) knowing the limitations of their approach.

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Authors and Affiliations

  1. Department of Urology, Sheffield Teaching Hospitals, Sheffield, UK

    Altaf Mangera FRCS(Urol), MD, FEBU

Authors
  1. Altaf Mangera FRCS(Urol), MD, FEBU
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Correspondence to Altaf Mangera FRCS(Urol), MD, FEBU .

Editor information

Editors and Affiliations

  1. Urology, The Royal Hallamshire Hospital, Sheffield, United Kingdom

    Christopher R. Chapple

  2. West Pavilion, 3rd Floor, Urology, Perelman Center, Philadelphia, Pennsylvania, USA

    Alan J. Wein

  3. Specialty Registrar, The Royal Hallamshire Hospital, Sheffield, South Yorkshire, United Kingdom

    Nadir I. Osman

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© 2017 Springer International Publishing Switzerland

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Mangera, A. (2017). Invasive Diagnostic Tests. In: Chapple, C., Wein, A., Osman, N. (eds) Underactive Bladder. Springer, Cham. https://doi.org/10.1007/978-3-319-43087-4_3

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  • DOI: https://doi.org/10.1007/978-3-319-43087-4_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43085-0

  • Online ISBN: 978-3-319-43087-4

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