Estimation of bladder contractility from intravesical pressure-volume measurements

Christopher Fry, A Gammie, Marcus Drake, P Abrams, Darryl Kitney, Bahareh Vahabi

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Aims
To describe parameters from urodynamic pressure recordings that describe urinary bladder contractility through the use of principles of muscle mechanics.

Methods
Subtracted detrusor pressure and voided flow were recorded from patients undergoing filling cystometry. The isovolumetric increase of detrusor pressure, P, of a voluntary bladder contraction before voiding was used to generate a plot of (dP/dt)/P versus P. Extrapolation of the plot to the y-axis and the x-axis generated a contractility parameter, vCE (the maximum rate of pressure development) and the maximum isovolumetric pressure, P0, respectively. Similar curves were obtained in ex vivo pig bladders with different concentrations of the inotropic agent carbachol and shown in a supplement.

Results
Values of vCE, but not P0, diminished with age in female subjects. vCE was most significantly associated with the 20–80% duration of isovolumetric contraction t20–80; and a weaker association with maximum flow rate and BCI in women. P0 was not associated with any urodynamic variable in women, but in men was with t20–80 and isovolumetric pressure indices.

Conclusions
The rate of isovolumetric subtracted detrusor pressure (t20–80) increase shows a very significant association with indices of bladder contractility as derived from a derived force–velocity curve. We propose that t20–80 is a detrusor contractility parameter (DCP).
Original languageEnglish
Number of pages6
JournalNeurourology and Urodynamics
Publication statusPublished - 6 Jun 2016

Bibliographical note

17-May-2016

Structured keywords

  • Centre for Surgical Research

Keywords

  • bladder
  • contractility
  • force–velocity relationship
  • urodynamics

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