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#23064

Diagnosis of detrusor contraction strength and detrusor underactivity in female patients. Rosier P1 1. University Medical Center Utrecht KEYWORDS: Voiding Dysfunction , Female, Urodynamics Techniques Although many adult women have lower urinary tract (LUT) symptoms and dysfunction, the specific incidence of voiding disorders in women is relatively low, especially when compared to LUT dysfunction in men. Clearly, when the higher age cohorts are considered, bladder outflow obstruction (BOO) plays a significantly greater role in men in association with BPH. Nevertheless, underactive detrusor contraction (DU) and likely deterioration of the contractile quality (and quantity) of the detrusor muscle play a role in both sexes. Although ineffective or prolonged voiding in women is less common, an objective and correct diagnosis of the pathophysiology of (detrusor) dysfunction is useful in many cases, especially in secondary care. The quantification of detrusor contraction force in men is, based on the currently known physiology of micturition, neither very complex nor very controversial. In women, the micturition usually has a higher outflow rate, which means a much faster detrusor contraction (muscle shortening speed). Determining the detrusor force at such a high contraction speed is less straightforward and does not lead to clinical results so unambiguously. Standard parameters for detrusor contraction force on the basis of pressure flow studies are Watts factor, and BCI, which are especially satisfactory for analysis of men. Watts factor (maximum) and BCI do not differ in a clinically significant way in men especially not if there is some bladder outflow obstruction. These parameters seem however less applicable and are less validated in women, several researchers find a moderate association with symptoms and or ineffective micturition when using the standard parameters. Some research suggests an adjustment to the BCI for women. Especially also a change from BCI= pdetQmax +5Qmax to BCI= pdetQmax + Qmax (also labelled as PIP (or DECO when PIP/100)) is suggested to better associate with stop flow testing. (https://doi.org/10.1002/nau.20020 and or 10.1016/j.purol.2019.11.004). We tested whether pressure flow study (PFS) –analysis parameters associated with ineffective voiding; high PVR and low Void%, and whether the alternative BCI is a better predictor of voiding dysfunction in women.