Abstract
The urodynamic test that assesses the voiding phase of bladder function is the pressure-flow study. Under normal conditions, a coordinated detrusor contraction and non-obstructive outlet results in a predictable low pressure, high flow pattern. A high pressure-low flow state is seen in patients with an obstructive bladder outlet. Low pressures-low flow states are seen in conditions of poor or absent detrusor contractility. The primary utility of the pressure-flow study is using the results to differentiate patients with an obstructive vs. non-obstructive flow pattern. Nomograms have been developed which are used to classify patients based on pressure-flow patterns.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Gleason DM, Lattimer JK. The pressure-flow study: a method for measuring bladder neck resistance. J Urol. 1962;87:844–52.
Schäfer W. Urethral resistance? Urodynamic concepts of physiological and pathological bladder outlet function during voiding. NeurourolUrodyn. 1985;4(3):161–201.
Conrad WA. Pressure–flow relationships in collapsible tubes. IEEE Trans Biomed Eng. 1969;16(4):284–95.
Griffiths DJ. Urethral elasticity and micturition hydrodynamics in females. Med Biol Eng. 1969;7(2):201–15.
Griffiths D, et al. Standardization of terminology of lower urinary tract function: pressure-flow studies of voiding, urethral resistance, and urethral obstruction. International Continence Society Subcommittee on Standardization of Terminology of Pressure-Flow Studies. NeurourolUrodyn. 1997;16(1):1–18.
Schäfer W. Principles and clinical application of advanced urodynamic analysis of voiding function. Urol Clin North Am. 1990;17(3):553–66.
Griffiths DJ. Hydrodynamics of male micturition. I. Theory of steady flow through elastic-walled tubes. Med Biol Eng. 1971;9(6):581–8.
Griffiths DJ. The mechanics of the urethra and of micturition. Br J Urol. 1973;45(5):497–507.
Nitti VW. Pressure flow urodynamic studies: the gold standard for diagnosing bladder outlet obstruction. Rev Urol. 2005;7 Suppl 6:S14–21.
Blaivas J. Multichannel urodynamic studies. Urology. 1984;23(5):421–38.
Abrams PH, Griffiths DJ. The assessment of prostatic obstruction from urodynamic measurements and from residual urine. Br J Urol. 1979;51(2):129–34.
Griffiths D. Basics of pressure-flow studies. World J Urol. 1995;13(1):30–3.
Lim CS, Abrams P. The Abrams-Griffiths nomogram. World J Urol. 1995;13(1):34–9.
Cox L, Jaffe WI. Urodynamics in male LUTS: when are they necessary and how do we use them? Urol Clin North Am. 2014;41(3):399–407.
Sekido N. Bladder contractility and urethral resistance relation: what does a pressure flow study tell us? Int J Urol. 2012;19(3):216–28.
Javle P, et al. Grading of benign prostatic obstruction can predict the outcome of transurethral prostatectomy. J Urol. 1998;160(5):1713–7.
Gotoh M, et al. Prognostic value of pressure-flow study in surgical treatment of benign prostatic obstruction. World J Urol. 1999;17(5):274–8.
Rodrigues P, et al. Urodynamic pressure flow studies can predict the clinical outcome after transurethral prostatic resection. J Urol. 2001;165(2):499–502.
Onyishi SE, Twiss CO. Pressure flow studies in men and women. Urol Clin North Am. 2014;41(3):453–67.
Scarpero H. Urodynamics in the evaluation of female LUTS: when are they helpful and how do we use them? Urol Clin North Am. 2014;41(3):429–38.
Carlson KV, Fiske J, Nitti VW. Value of routine evaluation of the voiding phase when performing urodynamic testing in women with lower urinary tract symptoms. J Urol. 2000;164(5):1614–8.
Monz B, et al. Patient characteristics associated with quality of life in European women seeking treatment for urinary incontinence: results from PURE. Eur Urol. 2007;51(4):1073–81. discussion 1081–2.
Irwin DE, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50(6):1306–14. discussion 1314–5.
Defreitas GA, et al. Refining diagnosis of anatomic female bladder outlet obstruction: comparison of pressure-flow study parameters in clinically obstructed women with those of normal controls. Urology. 2004;64(4):675–9. discussion 679–81.
Nitti VW, Tu LM, Gitlin J. Diagnosing bladder outlet obstruction in women. J Urol. 1999;161(5):1535–40.
Blaivas JG, Groutz A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. NeurourolUrodyn. 2000;19(5):553–64.
Groutz A, Blaivas JG. Bladder outlet obstruction in women: definition and characteristics. NeurourolUrodyn. 2000;19(3):213–20.
Osman NI, et al. Detrusor underactivity and the underactive bladder: a new clinical entity? A review of current terminology, definitions, epidemiology, aetiology, and diagnosis. Eur Urol. 2014;65(2):389–98.
Schäfer W. Analysis of bladder-outlet function with the linearized passive urethral resistance relation, linPURR, and a disease-specific approach for grading obstruction: from complex to simple. World J Urol. 1995;13(1):47–58.
Abrams P. Bladder outlet obstruction index, bladder contractility index and bladder voiding efficiency: three simple indices to define bladder voiding function. BJU Int. 1999;84(1):14–5.
Thomas AW, et al. The natural history of lower urinary tract dysfunction in men: the influence of detrusor underactivity on the outcome after transurethral resection of the prostate with a minimum 10-year urodynamic follow-up. BJU Int. 2004;93(6):745–50.
Mitchell CR, et al. Efficacy of holmium laser enucleation of the prostat in patients with non-neurogenic impaired bladder: results of a prospective trial. Urology. 2014;83(2):428–32.
Han DH, et al. The efficacy of transurethral resection of the prostate in the patients with weak bladder contractility index. Urology. 2008;71(4):657–61.
Blatt AH, et al. Transurethral prostate resection in patients with hypocontractile detrusor–what is the predictive value of ultrastructural detrusor changes? J Urol. 2012;188(6):2294–9.
Seki N, et al. Predictives regarding outcome after transurethral resection for prostatic adenoma associated with detrusor underactivity. URL. 2006;67(2):306–10.
Tanaka Y, et al. Is the short-term outcome of transurethral resection of the prostate affected by preoperative degree of bladder outlet obstruction, status of detrusor contractility or detrusor overactivity? Int J Urol. 2006;13(11):1398–404.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Anderson, K.M., Hadley, D.A. (2016). The Pressure Flow Study. In: Peterson, A., Fraser, M. (eds) Practical Urodynamics for the Clinician. Springer, Cham. https://doi.org/10.1007/978-3-319-20834-3_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-20834-3_6
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-20833-6
Online ISBN: 978-3-319-20834-3
eBook Packages: MedicineMedicine (R0)