Abstract
Neither clinical investigation alone nor conventional filling cystometry can be regarded as methods of choice for making a diagnosis of detrusor instability. Rather, some kind of provocative cystometry is often needed. This article reviews these along with recent advances, including hyperdiuresis cystometry and the ‘mobile urodynamic investigation’. Particular emphasis is also placed on the acceleration of flow rate, a parameter which can be easily derived from a simple, non-invasive free-flow uroflowmetry. Its rationale for use in clinical testing is described.
Similar content being viewed by others
References
Abrams PH, Blaivas JG, Stanton SL, Andersen JT. The standardisation of terminology of lower urinary tract function. Scand J Urol Nephrol [Suppl] 1988; 114:5–19
Turner-Warwick RT, Milroy EJ. A re-appraisal of the value of routine urological procedures in the assessment of urodynamic function. Urol Clin North Am 1979; 6:63–70
Abrams PH, Feneley RCL, Torrens MJ. Urodynamics. Berlin Heidelberg New York: Springer, 1983
Walter S. Detrusor hyper-reflexia in female urinary incontinence treated pharmacologically. Urol Int 1978; 33:316–321
Turner-Warwick RT. Observations on the function and dysfunction of the sphincter and detrusor mechanisms. Urol Clin North Am 1979; 6:13–30
Blaivas JG. A critical appraisal of specific diagnostic techniques. In: Krane RJ, Siroky MB, eds. Clinical neuro-urology. Boston: Little, Brown, 1979: 69–109
Awad SA, McGinnis RH. Factors that influence the incidence of detrusor instability in women. J Urol 1983; 130:114–115
Merrill DC. Air cystometer: a new instrument for evaluating bladder function. J Urol 1971; 106:865–866
Abrams PH. The practice of urodynamics. In: Mundy AR, Stephenson TP, Wein AJ, eds. Urodynamics, Principles, practice and application. Edinburgh: Churchill Livingstone, 1984; 76–92
Nordling J, Meyhoff HH, Andersen JT, Walter S. Urinary incontinence in the female. The value of detrusor reflex activation procedures. Br J Urol 1979; 51:110–113
van Duyl WA. Spontaneous contractions in urinary bladder smooth muscle: preliminary results. Neurourol Urodyn 1985; 4:301–307
Iggo A. Tension receptors in the stomach and urinary bladder. J Physiol (Lond) 1955; 128:593–607
Bradley WE. Micturition reflex amplification. J Urol 1969; 101:403–407
Kuru M. Nervous control of micturition. Physiol Rev 1965; 45:425–494
Bradley WE, Timm GW, Scott FB. Innervation of the detrusor muscle and urethra. Urol Clin North Am 1984; 1:3–27
Whiteside G, Bates P. Synchronous video-pressure-flow cystourethrography. Urol Clin North Am 1979; 6:93–102
Schmidt RA. Urethrovesical reflexes and their inhibition. In: Hinman F Jr, Boyarsky S, eds. Benign prostatic hypertrophy. Berlin Heidelberg New York: Springer, 1983: 361–372
Chalfin SA, Bradley WE. The etiology of detrusor hyperreflexia in patients with infravesical obstruction. J Urol 1982; 127:938–942
Andersen JT, Bradley WE. Cystometry: detrusor reflex activation, classification and terminology. J Urol 1977; 118:623–625
Coolsaet BLRA, Elhilali MM. Detrusor overactivity. Neurourol Urodyn 1988; 7:541–561
Blok C, Coolsaet BLRA, Mansour M, Razzouk A. Dynamics of the ureterovesical junction: interaction between diuresis and detrusor instability at the ureterovesical junction in the pig. J Urol 1986; 136:1123–1126
James ED. Ambulatory monitoring in urodynamics. In: Mundy AR, Stephenson TP, Wein AJ, eds. Urodynamics. Principles, practice and application. Edinburgh: Churchill Livingstone, 1984: 120–126
Thüroff JW, Jonas U, Petri E, Frohnenberg D. Telemetric urodynamic investigations in female incontinence. In: Zinner NR, Sterling AM, eds. Female incontinence. New York: Alan R Liss, 1981: 211–222
Bhatia NN, Bradley WE, Haldeman S. Urodynamics: continuous monitoring. J Urol 1982; 128:963–968
Griffiths CJ, Assi MS, Styles RA, Ramsden PD, Neal DE. Ambulatory monitoring of bladder and detrusor pressure during natural filling. J Urol 1989; 142:780–784
Janknegt RA, van Waalwijk van Doom ESC. Clinical experiences with ambulatory urodynamics. Neurourol Urodyn 1989; 8:402–404
Cucchi A. Acceleration of flow rate as a screening test for detrusor instability in women with stress incontinence. Br J Urol 1990; 65:17–19
Susset JG. Development of nomograms for application of uroflowmetry. In: Hinman F Jr, Boyarsky S, eds. Benign prostatic hypertrophy. Berlin Heidelberg New York: Springer, 1983: 528–538
Kinder RB, Mundy AR. Pathophysiology of idiopathic detrusor instability and detrusor hyper-reflexia. Br J Urol 1987; 60:509–515
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cucchi, A. Screening tests for detrusor instability in clinical urodynamics. Int Urogynecol J 2, 101–104 (1991). https://doi.org/10.1007/BF00376572
Issue Date:
DOI: https://doi.org/10.1007/BF00376572