Pressureflow Studies

The simultaneous measurement of detrusor pressure and urine flow during voiding offers valuable objective evidence for diagnosis of BOO in women. This is based on the physical principle that obstruction exists in a fluid-

transporting system if an elevated pressure is required to transport the usual rate of flow through a relative narrowing. Several groups have attempted to study obstruction in women on the basis of pressure-flow analysis. Massey and Abrams7 defined the BOO at Qmax less than 12mL/s, PdetQmaX more than 50 cm H2O, urethral resistance (PdetQmax/ Qmax) more than 0.2, and "significant" residual urine. Farrar et al.8 used an arbitrary definition based on Qmax of less than 15mL/s and PdetQmax of more than 50 cm H2O. Chassagne et al.9 reported that Qmax of 15mL/s or less and PdetQmax more than 20 cm H2O are reasonable pressure-flow parameters to define female BOO. Blaivas and Groutz10 constructed a normogram for women with lower urinary tract symptoms. We suspect obstruction when Qmax is less than 12mL/s and PdetQmax is more than 30 cm H2O.

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