Introduction to a new technology for measuring urethral pressures: 3D high-resolution manometry
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Introduction and hypothesis
This video introduces a 3D high-resolution manometry (HRM) system to the field of urogynecology. We demonstrate how to obtain and interpret dynamic urethral pressures with this measurement system and use it to evaluate pre- and postoperative women.
The 3D HRM catheter is ∼12 F; 11 cm of its length has pressure sensors with eight circumferentially distributed pressure-sensitive segments that collect and transmit individual pressure measurements to construct a 3D pressure map. In this video, we demonstrate the output display of the 3D HRM measurement system.
Pressure output maps are shown for one woman with stress urinary incontinence (SUI) and one with a history of SUI who underwent successful midurethral sling insertion. We also show a summary of 3D pressure-measurement patterns of 44 women who underwent pressure measurements to evaluate qualitatively the 3D pressure profile of the urethra in an effort to better understand pelvic floor and urethral sphincter physiology.
Advanced HRM technology to measure urethral pressures under cough and strain conditions without withdrawal techniques provides new insights into the continence mechanism in continent and incontinent women and after continence surgeries.
KeywordsHigh-resolution manometry 3D Urethral pressure profile Maximum urethral closure pressures Stress urinary incontinence Midurethral sling Urodynamics
Technical assistance and the high resolution manometry system were provided by Tom Parks and Dave Costarella at Given Imaging. This work was performed at the UC San Diego Health System.
Conflicts of interest
Support for this work was provided by NIH/NIDDK grant number R21DK090434-02.
(MP4 36525 kb)