One in three men will develop lower urinary tract symptoms (LUTS) in later life. These symptoms can be attributed either to bladder outflow obstruction or to a weak bladder contraction. While conventional cystometry can in principle separate the two groups, such measurements are expensive, time consuming, uncomfortable and have some morbidity. Therefore, prostatectomy is often undertaken on the basis of symptoms and flow-rate only. A quick, non-invasive means for measuring voiding function would be of considerable benefit to such patients.
We are investigating the use of an inflatable penile cuff to obstruct flow progressively during emptying of the bladder. We make continuous recordings of cuff pressure and urine flow rate, which give characteristic pressure-flow graphs for normal and obstructed subjects. The flow typically maintains a fixed value to a knee-point pressure, beyond which it falls steadily to zero. We believe this characteristic conveys important information about the function of the bladder and outlet. The aim of this study was to determine the precise relevance of each feature of the pressure-flow characteristic, using a simple experimental model of the bladder-outlet-cuff system.
We believe our findings may be of significant benefit in understanding and managing patients with outflow disorders, particularly the role of the putative flow-controlling zone. We now plan to test our hypotheses formally in a large group of both symptomatic and asymptomatic subjects.
Drinnan MJ, Pickard RS, Ramsden PD, Reddy M, Macdonald A, Robson W,Hewart P, Griffiths CJ. An experimental model reproducing the response of urine flow rate to penile cuff pressure observed in men. Neurourol Urodynam 2000;19:486.
Clive J. Griffiths or Dr. Michael J. Drinnan, Freeman Unit, Newcastle upon Tyne. Tel: +44 (0)191-223-6161.
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
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