Skip to main content
SpringerLink
Log in

Peut-on évaluer le débit urinaire maximal et le résidu postmictionnel par l’échelle visuelle analogique (EVA) ? Une étude prospective chez 31 patients

Can the urinary maximum flow rate and postvoid residual be assessed through a visual analogue scale (VAS)? A prospective study of 31 patients

  • Article Original / Original Article
  • Published:
Pelvi-périnéologie

Résumé

Objectif|

Le but de cette étude était de comparer les résultats de la débitmétrie et de la mesure du résidu postmictionnel (RPM) par échographie sus-pubienne au ressenti du patient évalué à l’aide d’une échelle visuelle analogique (EVA).

Matériel et méthodes|

Une étude prospective a été menée auprès de 31 patients (26 hommes et cinq femmes) âgés en moyenne de 63,74 ± 12,37 ans ayant consulté en urologie pour des troubles urinaires du bas appareil. Tous les patients ont eu une débitmétrie ainsi qu’une mesure par échographie du RPM. Les données étudiées étaient: l’âge, la présence d’une maladie neurologique, les antécédents chirurgicaux, le débit maximum (Q max ), le volume uriné, le RPM mesuré par échographie, les données de l’EVA concernant la force du jet urinaire (EVA Q max ) et le RPM (EVArpm).

Résultats|

Les résultats de l’EVA du jet urinaire maximal n’étaient pas statistiquement corrélés au débit maximum (Q max /EVA Q max : r2 = 0,005993; IC 95 %: −0,2911 à 0,4259; p = 0,6843). Une sensation de mauvaise vidange vésicale était exprimée chez dix parmi les 31 patients. Le résultat de l’autoévaluation par EVA était statistiquement corrélé au volume du RPM (r2 = 0,1485; IC 95 %: 0,02184 à 0,6589; p = 0,039). Aucune corrélation n’a été trouvée entre la dysurie (Q max < 15 ml/s) et la sensation de mauvaise vidange vésicale. Il n’y avait pas de lien statistique entre l’autoévaluation de la force du jet urinaire et celle de la vidange vésicale.

Conclusion|

L’intensité du trouble mictionnel tel qu’il est vécu par le patient est très différente de la réalité urodynamique. Une évaluation plus fine des symptômes, combinée éventuellement à des moyens de mesures non invasifs, pourrait améliorer la prise en charge de ces patients.

Abstract

Objective|

The purpose of this study was to compare uroflowmetry and ultrasound postvoid residue measurement results of data collected with patient feelings recorded through a visual analogue scale (VAS).

Material and methods|

Thirty-one patients, 26 men and five women, mean age 63.74 ± 12.37 years, consulting in urology for lower urinary tract symptoms were enrolled in a prospective study. All patients had an uroflowmetry and an ultrasound postvoid residue (PVR) measurement. Self-assessment by VAS of the strength of urinary stream and the feeling of complete bladder voiding were performed in all patients. Data collected were age, presence of a neurological disease, previous surgery, maximum flow rate (Q max ), voided volume, postvoid residue, VAS results of the strength of the urinary stream (VAS Q max ), and postvoid residue (VASrpm).

Results|

Maximum flow rate VAS results were not correlated to the maximum flow rate (Q max /VAS Q max : r2 = 0.005993; 95% CI: −0.2911 to 0.4259; P = 0.6843). The incomplete bladder emptying sensation was expressed by 10 out of 31 patients. Postvoid residue VAS results were correlated to the measured residue volume (r2 = 0.1485; 95% CI: 0.02184 to 0.6589; P = 0.039). No correlation was found between the flow impairment (Q max <15 ml/s) and the sensation of incomplete bladder emptying. No statistical link was found between the self-assessment of the strength of the urinary stream and the feeling of incomplete bladder emptying.

Conclusion|

The severity of voiding disorders as experienced by the patient is very different from the urodynamic reality. A more detailed evaluation of symptoms, probably combined with noninvasive measures, could improve the management of these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abbreviations

EVA:

échelle visuelle analogique

EVArpm :

échelle visuelle analogique du résidu postmictionnel

EVA Q max :

échelle visuelle analogique de la force du jet urinaire

ICS:

International Continence Society

Q max :

débit maximum à la débitmétrie

RPM:

résidu postmictionnel

TVT®:

Tension-free Vaginal Tape

Vs:

versus

Références

  1. Coyne KS, Sexton CC, Thompson CL, et al (2009) The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int 104(3):352–60

    Article  PubMed  Google Scholar 

  2. Cohen DD, Steinberg JR, Rossignol M, et al (2002) Normal variation and influence of stress, caffeine intake, and sexual activity on uroflowmetry parameters of a middle-aged asymptomatic cohort of volunteer male urologists. Neurourol Urodyn 21(5):491–4

    Article  PubMed  Google Scholar 

  3. Eryildirim B, Tarhan F, Kuyumcuoğlu U, et al (2006) Positionrelated changes in uroflowmetric parameters in healthy young men. Neurourol Urodyn 25(3):249–51

    Article  PubMed  Google Scholar 

  4. Schäfer W, Abrams P, Liao L, et al (2002) Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies; International Continence Society. Neurourol Urodyn 21(3):261–74

    Article  PubMed  Google Scholar 

  5. Reynard JM, Yang Q, Donovan JL, et al (1998) The ICS-“BPH” study: uroflowmetry, lower urinary tract symptoms and bladder outlet obstruction. Br J Urol 82(5):619–23

    PubMed  CAS  Google Scholar 

  6. Reynard JM, Peters TJ, Lim C, et al (1996) The value of multiple free-flow studies in men with lower urinary tract symptoms. Br J Urol 77(6):813–8

    PubMed  CAS  Google Scholar 

  7. Oelke M, Höfner K, Wiese B, et al (2002) Increase in detrusor wall thickness indicates bladder outlet obstruction (BOO) in men. World J Urol 19(6):443–52

    PubMed  Google Scholar 

  8. Ukimura O, Kojima M, Iwata T, et al (2003) Ultrasonic measurement of bladder weight as a novel urodynamic modality. Adv Exp Med Biol 539(Pt A):311–5

    PubMed  Google Scholar 

  9. Lin WY, Mannikarottu A, Li S, Juan YS, et al (2009) Correlation of in vivo bladder blood flow measurements with tissue hypoxia. World J Urol Epub

  10. Ku JH, Ko DW, Cho JY, Oh SJ (2010) Correlation between prostatic urethral angle and bladder outlet obstruction index in patients with lower urinary tract symptoms. Urology 75(6):1467–71

    Article  PubMed  Google Scholar 

  11. Chia SJ, Heng CT, Chan SP, Foo KT (2003) Correlation of intravesical prostatic protrusion with bladder outlet obstruction. BJU Int 91(4):371–4

    Article  PubMed  CAS  Google Scholar 

  12. Barry MJ, Williford WO, Chang Y, et al (1995) Benign prostatic hyperplasia specific health status measures in clinical research: how much change in the American Urological Association symptom index and the benign prostatic hyperplasia impact index is perceptible to patients?J Urol 154:1770–4

    Article  PubMed  CAS  Google Scholar 

  13. Steele GS, Sullivan MP, Sleep DJ, et al (2000) Combination of symptom score, flow rate and prostate volume for predicting bladder outflow obstruction in men with lower urinary tract symptoms. J Urol 164(2):344–8

    Article  PubMed  CAS  Google Scholar 

  14. Sirls LT, Kirkemo AK, Jay J (1996) Lack of correlation of the American Urological Association Symptom 7 Index with urodynamic bladder outlet obstruction. Neurourol Urodyn 15(5): 447–56

    Article  PubMed  CAS  Google Scholar 

  15. Jepsen JV, Bruskewitz RC (1998) Comprehensive patient evaluation for benign prostatic hyperplasia. Urology 51(4A Suppl):13–8

    Article  PubMed  CAS  Google Scholar 

  16. Vesely S, Knutson T, Damber JE, et al (2003) Relationship between age, prostate volume, prostate-specific antigen, symptom score and uroflowmetry in men with lower urinary tract symptoms. Scand J Urol Nephrol 37(4):322–8

    Article  PubMed  Google Scholar 

  17. Seki N, Yunoki T, Tomoda T, et al (2008) Association among the symptoms, quality of life and urodynamic parameters in patients with improved lower urinary tract symptoms following a transurethral resection of the prostate. Neurourol Urodyn 27(3):222–5

    Article  PubMed  Google Scholar 

  18. Eckhardt MD, van Venrooij GE, Boon TA (2001) Symptoms and quality of life versus age, prostate volume, and urodynamic parameters in 565 strictly selected men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Urology 57(4):695–700

    Article  PubMed  CAS  Google Scholar 

  19. Mattiasson A, Djurhuus JC, Fonda D, et al (1998) Standardisation of outcome studies in patients with lower urinary dysfunction: a report on general principles from the Standardisation Committee of the International Continence Society. Neurourol Urodyn 17:249–53

    Article  PubMed  CAS  Google Scholar 

  20. Dompeyre P, Fritel X, Bader G, et al (2007) Bladder sensitivity testing using a visual analogue scale: comparative cystometric study on women. Neurourol Urodyn 26(3):350–5

    Article  PubMed  Google Scholar 

  21. De Wachter S, Van Meel TD, Wyndaele JJ (2008) Can a faked cystometry deceive patients in their perception of filling sensations? A study on the reliability of spontaneously reported cystometric filling sensations in patients with nonneurogenic lower urinary tract dysfunction. Neurourol Urodyn 27(5):395–8

    Article  PubMed  Google Scholar 

  22. Lowenstein L, FitzGerald MP, Kenton K, et al (2008) Validation of a real-time urodynamic measure of urinary sensation. Am J Obstet Gynecol 198(6):661.e1–4

    Article  Google Scholar 

  23. Walden M, Geirsson G, Pettersson S, et al (1995) Does anamnestic symptom evaluation or clinical examination give enough information to evaluate the severity of obstruction in benign prostatic hyperplasia? Scand J Urol Nephrol 29:469–76

    Article  PubMed  CAS  Google Scholar 

  24. Abrams PH, Griffiths DJ (1979) The assessment of prostatic obstruction from urodynamic measurements and from residual urine. Br J Urol 51(2):129–34

    Article  PubMed  CAS  Google Scholar 

  25. Mirone V, Imbimbo C, Longo N, Fusco F (2007) The detrusor muscle: an innocent victim of bladder outlet obstruction. Eur Urol 51(1):57–66

    Article  PubMed  Google Scholar 

  26. De Laet K, De Wachter S, Van Meel T, Wyndaele JJ (2010) How do different tests evaluate sensation in the lower urinary tract? Scand J Urol Nephrol 44(3):158–64

    Article  PubMed  Google Scholar 

  27. Naoemova I, De Wachter S, Wyndaele JJ (2008) Comparison of sensation-related voiding patterns between continent and incontinent women: a study with a 3-day sensation-related bladder diary (SR-BD). Neurourol Urodyn 27(6):511–4

    Article  PubMed  Google Scholar 

  28. Birder L, de Groat W, Mills I, et al (2010) Neural control of the lower urinary tract: peripheral and spinal mechanisms. Neurourol Urodyn 29(1):128–39

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de chirurgie générale et d’urologie, centre hospitalier Montauban, 100, rue Léon-Cladel, F-82013, Montauban, France

    W. Chaabane

  2. Service de chirurgie urologique et de transplantation rénale, CHU Rangeuil, 1 avenue Jean Poulhès, TSA 50032, F-31059, Toulouse cedex, France

    X. Gamé, B. Malavaud & P. Rischmann

  3. Service de chirurgie urologique et de transplantation rénale, hôpital de la Conception, 147 boulevard Baille, F-13385, Marseille cedex 05, France

    G. Karsenty

Authors
  1. W. Chaabane
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. X. Gamé
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Malavaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Rischmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Karsenty
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W. Chaabane.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chaabane, W., Gamé, X., Malavaud, B. et al. Peut-on évaluer le débit urinaire maximal et le résidu postmictionnel par l’échelle visuelle analogique (EVA) ? Une étude prospective chez 31 patients. Pelv Perineol 6, 2–7 (2011). https://doi.org/10.1007/s11608-010-0349-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11608-010-0349-3

Mots clés

Keywords

Search

Navigation