Skip to main content
Top
Published in: International Urogynecology Journal 3/2012

01-03-2012 | Review Article

Normal urodynamic parameters in women

Part II—invasive urodynamics

Authors: Wally Mahfouz, Tala Al Afraa, Lysanne Campeau, Jacques Corcos

Published in: International Urogynecology Journal | Issue 3/2012

Login to get access

Abstract

Introduction and hypothesis

This literature review, providing reference ranges of normal variability in urodynamic parameters, is the second part of a two-part article. The first part addresses non-invasive urodynamics (UDS), while the second part addresses invasive techniques.

Methods

Data were obtained through MEDLINE from articles published between January 1956 and February 2011, International Continence Society meeting abstracts, and standardization reports. Search terms included cystometry, urethral pressure profilometry, leak point pressure, video UDS, normal volunteer, pressure flow studies, and electromyography.

Results

Normal values varied widely in the literature. However, with the help of clinical data, it was possible to define “normality” ranges for most of the different parameters.

Conclusions

Urodynamic evaluation of lower urinary tract (LUT) function is not a physiological test. However, it is still the best available tool for LUT function assessment. Even if normality in UDS can be defined, tests must always be interpreted against patient characteristics, complaints, and symptoms.
Literature
1.
go back to reference Abrams P (ed) (2006) Urodynamics. Springer, Singapore Abrams P (ed) (2006) Urodynamics. Springer, Singapore
2.
go back to reference Chapple CR, MacDiarmid S, Patel A (eds) (2009) Urodynamics made easy. Churchill Livingstone/Elsevier, Barcelona Chapple CR, MacDiarmid S, Patel A (eds) (2009) Urodynamics made easy. Churchill Livingstone/Elsevier, Barcelona
3.
go back to reference Schafer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A, Sterling AM, Zinner NR, van Kerrebroeck P (2002) Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 21:261–274PubMedCrossRef Schafer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A, Sterling AM, Zinner NR, van Kerrebroeck P (2002) Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 21:261–274PubMedCrossRef
4.
go back to reference Abrams PH, Dunn M, George N (1978) Urodynamic findings in chronic retention of urine and their relevance to results of surgery. Br Med J 2:1258–1260PubMedCrossRef Abrams PH, Dunn M, George N (1978) Urodynamic findings in chronic retention of urine and their relevance to results of surgery. Br Med J 2:1258–1260PubMedCrossRef
5.
go back to reference Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178PubMedCrossRef Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178PubMedCrossRef
6.
go back to reference Wyndaele JJ, De Wachter S (2002) Cystometrical sensory data from a normal population: comparison of two groups of young healthy volunteers examined with 5 years interval. Eur Urol 42:34–38PubMedCrossRef Wyndaele JJ, De Wachter S (2002) Cystometrical sensory data from a normal population: comparison of two groups of young healthy volunteers examined with 5 years interval. Eur Urol 42:34–38PubMedCrossRef
7.
go back to reference Blaivas JG, Chancellor M, Weiss J, Verhaaren M (eds) (2007) Atlas of urodynamics. Blackwell, Milton Blaivas JG, Chancellor M, Weiss J, Verhaaren M (eds) (2007) Atlas of urodynamics. Blackwell, Milton
8.
go back to reference Abrams P, Blaivas JG, Stanton SL, Andersen JT (1988) The standardisation of terminology of lower urinary tract function. The International Continence Society Committee on Standardisation of Terminology. Scand J Urol Nephrol Suppl 114:5–19PubMed Abrams P, Blaivas JG, Stanton SL, Andersen JT (1988) The standardisation of terminology of lower urinary tract function. The International Continence Society Committee on Standardisation of Terminology. Scand J Urol Nephrol Suppl 114:5–19PubMed
9.
go back to reference Bates P, Bradley WE, Glen E, Melchior H, Rowan D, Sterling A, Hald T (1976) The standardization of terminology of lower urinary tract function. Eur Urol 2:274–276PubMed Bates P, Bradley WE, Glen E, Melchior H, Rowan D, Sterling A, Hald T (1976) The standardization of terminology of lower urinary tract function. Eur Urol 2:274–276PubMed
10.
11.
go back to reference Sullivan MP, Yalla SV (1996) Detrusor contractility and compliance characteristics in adult male patients with obstructive and nonobstructive voiding dysfunction. J Urol 155:1995–2000PubMedCrossRef Sullivan MP, Yalla SV (1996) Detrusor contractility and compliance characteristics in adult male patients with obstructive and nonobstructive voiding dysfunction. J Urol 155:1995–2000PubMedCrossRef
12.
go back to reference Harris RL, Cundiff GW, Theofrastous JP, Bump RC (1996) Bladder compliance in neurologically intact women. Neurourol Urodyn 15:483–488PubMedCrossRef Harris RL, Cundiff GW, Theofrastous JP, Bump RC (1996) Bladder compliance in neurologically intact women. Neurourol Urodyn 15:483–488PubMedCrossRef
13.
go back to reference Wahl EF, Lerman SE, Lahdes-Vasama TT, Churchill BM (2004) Measurement of bladder compliance can be standardized by a dimensionless number: clinical perspective. BJU Int 94:898–900PubMedCrossRef Wahl EF, Lerman SE, Lahdes-Vasama TT, Churchill BM (2004) Measurement of bladder compliance can be standardized by a dimensionless number: clinical perspective. BJU Int 94:898–900PubMedCrossRef
14.
go back to reference Wahl EF, Lerman SE, Lahdes-Vasama TT, Churchill BM (2004) Measurement of bladder compliance can be standardized by a dimensionless number: theoretical perspective. BJU Int 94:895–897PubMedCrossRef Wahl EF, Lerman SE, Lahdes-Vasama TT, Churchill BM (2004) Measurement of bladder compliance can be standardized by a dimensionless number: theoretical perspective. BJU Int 94:895–897PubMedCrossRef
15.
go back to reference Pauwels E, De Wachter S, Wyndaele JJ (2004) Normality of bladder filling studied in symptom-free middle-aged women. J Urol 171:1567–1570PubMedCrossRef Pauwels E, De Wachter S, Wyndaele JJ (2004) Normality of bladder filling studied in symptom-free middle-aged women. J Urol 171:1567–1570PubMedCrossRef
16.
go back to reference Ouslander J, Leach G, Abelson S, Staskin D, Blaustein J, Raz S (1988) Simple versus multichannel cystometry in the evaluation of bladder function in an incontinent geriatric population. J Urol 140:1482–1486PubMed Ouslander J, Leach G, Abelson S, Staskin D, Blaustein J, Raz S (1988) Simple versus multichannel cystometry in the evaluation of bladder function in an incontinent geriatric population. J Urol 140:1482–1486PubMed
17.
go back to reference Peterson A, Webster G (eds) (2007) Urodynamic and videourodynamic evaluation of voiding dysfunction. Saunders, Philadelphia Peterson A, Webster G (eds) (2007) Urodynamic and videourodynamic evaluation of voiding dysfunction. Saunders, Philadelphia
18.
go back to reference McGuire EJ (1995) Urodynamic evaluation of stress incontinence. Urol Clin N Am 22:551–555 McGuire EJ (1995) Urodynamic evaluation of stress incontinence. Urol Clin N Am 22:551–555
19.
go back to reference Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, Cottenden A, Davila W, de Ridder D, Dmochowski R, Drake M, Dubeau C, Fry C, Hanno P, Smith JH, Herschorn S, Hosker G, Kelleher C, Koelbl H, Khoury S, Madoff R, Milsom I, Moore K, Newman D, Nitti V, Norton C, Nygaard I, Payne C, Smith A, Staskin D, Tekgul S, Thuroff J, Tubaro A, Vodusek D, Wein A, Wyndaele JJ (2010) Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 29:213–240PubMedCrossRef Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, Cottenden A, Davila W, de Ridder D, Dmochowski R, Drake M, Dubeau C, Fry C, Hanno P, Smith JH, Herschorn S, Hosker G, Kelleher C, Koelbl H, Khoury S, Madoff R, Milsom I, Moore K, Newman D, Nitti V, Norton C, Nygaard I, Payne C, Smith A, Staskin D, Tekgul S, Thuroff J, Tubaro A, Vodusek D, Wein A, Wyndaele JJ (2010) Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 29:213–240PubMedCrossRef
20.
go back to reference Bates CP, Bradley WE, Glen ES, Griffiths D, Melchior H, Rowan D, Sterling A, Hald T (1980) Third report on the standardisation of terminology of lower urinary tract function procedures related to the evaluation of micturition: pressure–flow relationships. Residual urine. Produced by the International Continence Society, February 1977. Br J Urol 52:348–350 Bates CP, Bradley WE, Glen ES, Griffiths D, Melchior H, Rowan D, Sterling A, Hald T (1980) Third report on the standardisation of terminology of lower urinary tract function procedures related to the evaluation of micturition: pressure–flow relationships. Residual urine. Produced by the International Continence Society, February 1977. Br J Urol 52:348–350
21.
go back to reference Bates CP, Bradley WE, Glen ES, Griffiths D, Melchior H, Rowan D, Sterling A, Hald T (1980) Third report on the standardisation of terminology of lower urinary tract function. Procedures related to the evaluation of micturition, pressure–flow relationships, residual urine. Produced by the International Continence Society Committee on Standardisation of Terminology, Nottingham, February 1977. Eur Urol 6:170–171 Bates CP, Bradley WE, Glen ES, Griffiths D, Melchior H, Rowan D, Sterling A, Hald T (1980) Third report on the standardisation of terminology of lower urinary tract function. Procedures related to the evaluation of micturition, pressure–flow relationships, residual urine. Produced by the International Continence Society Committee on Standardisation of Terminology, Nottingham, February 1977. Eur Urol 6:170–171
22.
go back to reference Abrams P (1999) Bladder outlet obstruction index, bladder contractility index and bladder voiding efficiency: three simple indices to define bladder voiding function. BJU Int 84:14–15PubMedCrossRef Abrams P (1999) Bladder outlet obstruction index, bladder contractility index and bladder voiding efficiency: three simple indices to define bladder voiding function. BJU Int 84:14–15PubMedCrossRef
23.
go back to reference Abrams P, Torrens M (1979) Urine flow studies. Urol Clin N Am 6:71–79 Abrams P, Torrens M (1979) Urine flow studies. Urol Clin N Am 6:71–79
25.
go back to reference Schafer W (1995) 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 13:47–58PubMedCrossRef Schafer W (1995) 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 13:47–58PubMedCrossRef
26.
go back to reference Eri LM, Wessel N, Tysland O, Berge V (2002) Comparative study of pressure-flow parameters. Neurourol Urodyn 21:186–193PubMedCrossRef Eri LM, Wessel N, Tysland O, Berge V (2002) Comparative study of pressure-flow parameters. Neurourol Urodyn 21:186–193PubMedCrossRef
27.
28.
go back to reference Dietz HP, Haylen BT, Vancaillie TG (2002) Female pelvic organ prolapse and voiding function. Int Urogynecol J Pelvic Floor Dysfunct 13:284–288PubMedCrossRef Dietz HP, Haylen BT, Vancaillie TG (2002) Female pelvic organ prolapse and voiding function. Int Urogynecol J Pelvic Floor Dysfunct 13:284–288PubMedCrossRef
29.
go back to reference Griffiths D, Hofner K, van Mastrigt R, Rollema HJ, Spangberg A, Gleason D (1997) 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. Neurourol Urodyn 16:1–18PubMedCrossRef Griffiths D, Hofner K, van Mastrigt R, Rollema HJ, Spangberg A, Gleason D (1997) 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. Neurourol Urodyn 16:1–18PubMedCrossRef
30.
go back to reference Webster G, Koefoot R (1983) The after contraction in urodynamic micturition studies. Neurourol Urodyn 2:213–218CrossRef Webster G, Koefoot R (1983) The after contraction in urodynamic micturition studies. Neurourol Urodyn 2:213–218CrossRef
31.
go back to reference Blaivas JG, Groutz A (2000) Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn 19:553–564PubMedCrossRef Blaivas JG, Groutz A (2000) Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn 19:553–564PubMedCrossRef
32.
go back to reference Defreitas GA, Zimmern PE, Lemack GE, Shariat SF (2004) Refining diagnosis of anatomic female bladder outlet obstruction: comparison of pressure-flow study parameters in clinically obstructed women with those of normal controls. Urology 64:675–679, discussion 679–81PubMedCrossRef Defreitas GA, Zimmern PE, Lemack GE, Shariat SF (2004) Refining diagnosis of anatomic female bladder outlet obstruction: comparison of pressure-flow study parameters in clinically obstructed women with those of normal controls. Urology 64:675–679, discussion 679–81PubMedCrossRef
33.
go back to reference Chassagne S, Bernier PA, Haab F, Roehrborn CG, Reisch JS, Zimmern PE (1998) Proposed cutoff values to define bladder outlet obstruction in women. Urology 51:408–411PubMedCrossRef Chassagne S, Bernier PA, Haab F, Roehrborn CG, Reisch JS, Zimmern PE (1998) Proposed cutoff values to define bladder outlet obstruction in women. Urology 51:408–411PubMedCrossRef
34.
go back to reference Brostrom S, Jennum P, Lose G (2002) Short-term reproducibility of cystometry and pressure-flow micturition studies in healthy women. Neurourol Urodyn 21:457–460PubMedCrossRef Brostrom S, Jennum P, Lose G (2002) Short-term reproducibility of cystometry and pressure-flow micturition studies in healthy women. Neurourol Urodyn 21:457–460PubMedCrossRef
35.
go back to reference Kuo HC (2004) Urodynamic parameters for the diagnosis of bladder outlet obstruction in women. Urol Int 72:46–51PubMedCrossRef Kuo HC (2004) Urodynamic parameters for the diagnosis of bladder outlet obstruction in women. Urol Int 72:46–51PubMedCrossRef
37.
go back to reference McGuire EJ, Woodside JR, Borden TA, Weiss RM (1981) Prognostic value of urodynamic testing in myelodysplastic patients. J Urol 126:205–209PubMed McGuire EJ, Woodside JR, Borden TA, Weiss RM (1981) Prognostic value of urodynamic testing in myelodysplastic patients. J Urol 126:205–209PubMed
38.
go back to reference McGuire EJ, Fitzpatrick CC, Wan J, Bloom D, Sanvordenker J, Ritchey M, Gormley EA (1993) Clinical assessment of urethral sphincter function. J Urol 150:1452–1454PubMed McGuire EJ, Fitzpatrick CC, Wan J, Bloom D, Sanvordenker J, Ritchey M, Gormley EA (1993) Clinical assessment of urethral sphincter function. J Urol 150:1452–1454PubMed
39.
go back to reference McGuire EJ, Cespedes RD, O’Connell HE (1996) Leak-point pressures. Urol Clin North Am 23:253–262PubMedCrossRef McGuire EJ, Cespedes RD, O’Connell HE (1996) Leak-point pressures. Urol Clin North Am 23:253–262PubMedCrossRef
40.
go back to reference Corcos J, Schick E (eds) (2001) The urinary sphincter. Marcel Dekker, New York Corcos J, Schick E (eds) (2001) The urinary sphincter. Marcel Dekker, New York
41.
go back to reference Sorensen S, Waechter PB, Constantinou CE, Kirkeby HJ, Jonler M, Djurhuus JC (1991) Urethral pressure and pressure variations in healthy fertile and postmenopausal women with reference to the female sex hormones. J Urol 146:1434–1440PubMed Sorensen S, Waechter PB, Constantinou CE, Kirkeby HJ, Jonler M, Djurhuus JC (1991) Urethral pressure and pressure variations in healthy fertile and postmenopausal women with reference to the female sex hormones. J Urol 146:1434–1440PubMed
42.
go back to reference Van Geelen JM, Doesburg WH, Thomas CM, Martin CB Jr (1981) Urodynamic studies in the normal menstrual cycle: the relationship between hormonal changes during the menstrual cycle and the urethral pressure profile. Am J Obstet Gynecol 141:384–392PubMed Van Geelen JM, Doesburg WH, Thomas CM, Martin CB Jr (1981) Urodynamic studies in the normal menstrual cycle: the relationship between hormonal changes during the menstrual cycle and the urethral pressure profile. Am J Obstet Gynecol 141:384–392PubMed
43.
go back to reference Pfisterer MH, Griffiths DJ, Rosenberg L, Schaefer W, Resnick NM (2007) Parameters of bladder function in pre-, peri-, and postmenopausal continent women without detrusor overactivity. Neurourol Urodyn 26:356–361PubMedCrossRef Pfisterer MH, Griffiths DJ, Rosenberg L, Schaefer W, Resnick NM (2007) Parameters of bladder function in pre-, peri-, and postmenopausal continent women without detrusor overactivity. Neurourol Urodyn 26:356–361PubMedCrossRef
44.
go back to reference Nitti V (ed) (1998) Practical urodynamics. WB Sanders, Philadelphia Nitti V (ed) (1998) Practical urodynamics. WB Sanders, Philadelphia
45.
go back to reference Yalla SV, Sharma GV, Barsamian EM (1980) Micturitional static urethral pressure profile: a method of recording urethral pressure profile during voiding and the implications. J Urol 124:649–656PubMed Yalla SV, Sharma GV, Barsamian EM (1980) Micturitional static urethral pressure profile: a method of recording urethral pressure profile during voiding and the implications. J Urol 124:649–656PubMed
46.
go back to reference Blaivas JG, Sinha HP, Zayed AA, Labib KB (1981) Detrusor-external sphincter dyssynergia: a detailed electromyographic study. J Urol 125:545–548PubMed Blaivas JG, Sinha HP, Zayed AA, Labib KB (1981) Detrusor-external sphincter dyssynergia: a detailed electromyographic study. J Urol 125:545–548PubMed
47.
go back to reference O’Donnell P, Beck C, Doyle R, Eubanks C (1988) Surface electrodes in perineal electromyography. Urology 32:375–379PubMedCrossRef O’Donnell P, Beck C, Doyle R, Eubanks C (1988) Surface electrodes in perineal electromyography. Urology 32:375–379PubMedCrossRef
48.
go back to reference Sorensen SS, Nielsen JB, Norgaard JP, Knudsen LM, Djurhuus JC (1984) Changes in bladder volumes with repetition of water cystometry. Urol Res 12:205–208PubMedCrossRef Sorensen SS, Nielsen JB, Norgaard JP, Knudsen LM, Djurhuus JC (1984) Changes in bladder volumes with repetition of water cystometry. Urol Res 12:205–208PubMedCrossRef
49.
go back to reference Wyndaele JJ (1998) The normal pattern of perception of bladder filling during cystometry studied in 38 young healthy volunteers. J Urol 160:479–481PubMedCrossRef Wyndaele JJ (1998) The normal pattern of perception of bladder filling during cystometry studied in 38 young healthy volunteers. J Urol 160:479–481PubMedCrossRef
50.
go back to reference Corcos J, Schick E (eds) (1996) Les vessies neurogènes de l’adulte. Masson, Paris Corcos J, Schick E (eds) (1996) Les vessies neurogènes de l’adulte. Masson, Paris
51.
go back to reference Wall L, Norton P, De Lancey J (eds) (1993) Practical urogynecology. Williams and Wilkins, Baltimore Wall L, Norton P, De Lancey J (eds) (1993) Practical urogynecology. Williams and Wilkins, Baltimore
52.
go back to reference Mundy A, Stephenson T, Wein J (eds) (1984) Urodynamics. Principles, practice and application. Churchill Livingstone, Edinburgh Mundy A, Stephenson T, Wein J (eds) (1984) Urodynamics. Principles, practice and application. Churchill Livingstone, Edinburgh
53.
go back to reference Krane R, Siroky M (eds) (1991) Clinical neurourology. Little Brown & Co, Boston Krane R, Siroky M (eds) (1991) Clinical neurourology. Little Brown & Co, Boston
Metadata
Title
Normal urodynamic parameters in women
Part II—invasive urodynamics
Authors
Wally Mahfouz
Tala Al Afraa
Lysanne Campeau
Jacques Corcos
Publication date
01-03-2012
Publisher
Springer-Verlag
Published in
International Urogynecology Journal / Issue 3/2012
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-011-1585-y

Other articles of this Issue 3/2012

International Urogynecology Journal 3/2012 Go to the issue