Urodynamics/Incontinence/Female Urology: Urodynamic Testing - Annual Meeting Of The American Urological Association

Main Category: Urology / Nephrology
Article Date: 02 Jul 2008 - 7:00 PDT

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ORLANDO, FL (UroToday.com) - The moderated poster session covering urodynamic testing covered a variety of subjects. Several abstracts focused on the assessment of bladder sensation and related afferent or autonomic actions.

Tsang and colleagues (Abstract 1516) reported mapping studies using functional MRI during bladder filling in combination with urodynamic evaluation. Such study demonstrated the activation of several regions, including the anterior cingulated gyrus, insula, and peri-aquactal grey. Mehnert and associates (Abstract 1523) assess markers of autonomic activity (heart rate variability (HRV) and skin conductance level (SCL)). These authors identified associations between peaks in these markers and urodynamic periods of first sensation, first desire, and strong desire. Finally, Ukimura et al (Abtract 1524) evaluated the use of the Neurometer to identify current perception thresholds of A-delta and C afferent fibers. Hypersensitivity of both fiber types was associated with IC and OAB symptoms, helping to characterize potential abnormalities that may underlie these disorders. Combined, these abstracts underscore the importance of assessing afferent and autonomic actions in LUT disease given their potential contributing role.

Other diverse abstracts were notable. Lai and associates (Abstract 1529) assessed for urodynamic (URD) parameters predicting for negative outcomes following AUS placement for post-prostatectomy incontinence. In assessing a variety or pre-operative URD variables (DO, first sensation, capacity, compliance, detrusor contractile ability, etc), the authors reported that only low compliance negatively impacted continence outcomes. Realfonso et al (Abstract 1534) assessed the question of whether antibiotic prophylaxis is needed for patients undergoing URD study. Notably, this study was performed in a randomized and controlled fashion. The authors found a low prevalence (8.6%) of symptomatic UTI following URD. No statistical differences were identified in the incidence of patients with UTI between placebo and study groups.

ABST #1516: Functional MRI (fMIR) of Urodyanmics in Healthy Volunteers, by Woon Tsang, MD, et al.
ABST #1523: The Quest for an Objective Measure of Bladder Sensibility: A New Approach Using Heart Rate Variability and Skin Conductance Level Analysis in Urodynamics, by Ulrich Mehnert, MD, et al.
ABST #1524: Evaluation of Neuroselective Current Perception Threshold in Patients with Overactive Bladder or Interstitial Cystitis Indicated Coexistence of Hypersensitivity in Bladder Afferent A-Delta and C Fibers, by Osamu Ukimura, MD, et al.
ABST #1529: Does Having Adverse Urodynamic Features Negatively Impact the Results of Artificial Urinary Sphincter Surgery for Post-Prostatectomy Incontinence?, by H. Henry Lai, MD, et al.
ABST #1534: Is Antibiotic Prophylaxis Useful for Patients Undergoing Urodynamic Study?, by Tommaso Realfonso, MD, et al.

Presented at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor David Rapp, MD

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