Elsevier

Urology

Volume 66, Issue 5, November 2005, Pages 1000-1003
Urology

Adult urology
Is catheter cause of subjectivity in sensations perceived during filling cystometry?

https://doi.org/10.1016/j.urology.2005.05.056Get rights and content

Abstract

Objectives

To investigate the impact of the catheter on perceptions of filling. In our previous study, we demonstrated that some patients perceived sensations despite a lack of filling during cystometry.

Methods

The study included 45 patients with lower urinary tract symptoms attributed to benign prostatic hyperplasia. The average patient age was 57.9 years (range 48 to 79). Patients were draped to keep them from seeing their penis and the filling bag, pump, and screen process. In the first phase, the catheter was fixed to the penile skin without introducing it through the urethra, and the patient was told the test had begun. At the end of the first phase, the bladder was emptied. Before the second phase, an 8F urodynamic catheter was introduced, but during the test, nothing was infused. During the third phase, filling cystometry was performed with a 50-mL/min pump speed. The bladder was emptied after all three phases. The times that elapsed until each sensation was perceived, in seconds, were used to compare the sensations.

Results

In the first phase, 21 patients reported a first sensation, 10 reported first desire, and 4 reported normal desire, despite a lack of catheterization. No statistically significant difference was found between the mean first sensation/first desire, first sensation/normal desire, first desire/normal desire ratios of the patients who perceived sensations in the three phases and the strong desire/normal desire ratios of the patients in the second and third phases (P >0.05 for all).

Conclusions

Although the perceptions were reported in the first and second phases, the catheter could not be the sole cause of the subjectivity.

Section snippets

Material and methods

The study consisted of 45 men with lower urinary tract symptoms, attributed to benign prostatic hyperplasia. The mean patient age was 57.9 years (range 48 to 79). The exclusion criteria included drug treatment that could interfere with bladder function, neuromuscular dysfunction of the lower urinary tract, previous pelvic trauma or surgery, diabetes mellitus, and mental disturbances.

At the beginning of the test, verbal and written information about the possible sensations was given to the

Results

In the third phase, all patients reported sensations. However, in the first phase, of the 45 patients, 21 (46.7%) had an FS, 10 (22.2%) had an FD, and 4 (8.9%) had an ND, despite the lack of catheterization. None of the patients reported an SD. In the second phase, of the 45 patients, 39 (86.7%) had an FS, 33 (73.3%) had an FD, 24 (53.3%) had ND, and 8 (17.8%) had an SD, despite the lack of filling.

The number, mean, median, standard deviation, and minimal and maximal values of the time elapsed

Comment

Sensory input is essential for conscious bladder control, and pathologic bladder sensation may cause serious symptoms.7 However, sensations in the lower urinary tract are not easy to evaluate because of their subjectivity.2 To help alleviate this subjectivity, the use of objective and semiobjective tests was recommended by the International Continence Society, but confounding results still occur.5, 8 In our previous study, we reported that 49 (83%) of the 59 patients reported an FS, 47 (79.6%)

Conclusions

The urethral catheter is one of the factors contributing to the sensations reported during fake phases, but it is not the only one. Without a urethral catheter or bladder filling at all, nearly one half of the subjects reported an FS, one quarter reported an FD, and nearly 10% reported an ND to void. After insertion of the urethral catheter (but without bladder filling), most reported these sensations. The calculated ratios in the first and second phases were similar to those obtained with

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