ABSTRACT
Objective To establish typical value ranges (TVR) by analyzing cystometry data,andto verify their roles in real-time quantitative quality control. Methods Totally,582 data sets of free flow,filling,and voiding from cystometry 181 males(age range,43 -86 years)in a strictly quality-controlled studywere analyzed for Pves,Pabdand Pdetbefore,at beginning and end of filling,and after voiding,cystometric ca-pacity (MCC),Qmaxand Vvoid,and compliance.The mean values,standard deviation,median and variousTVRs of these parameters were calculated.Technical errors related to TVR were classified and examples giv-en. Results 50% TVRs for initial resting Pves,Pabdand Pdetwere 31 -42,28 -39 and 0 -4 cm H2O(1 cm H2O=0.098 kPa),respectively.Various technical errors were classified into typeⅠ:normal initialPdet,but both Pvesand Pabdwere wrong;typeⅡ:negative initial Pdet;and typeⅢ:too high initial Pdet.The in-cidences of typesⅠ,Ⅱ andⅢ errors were 9.8%(57/582),4.5%(26/582) and 1.4%(8/582),respec-tively.50% TVRs for MCC and compliance were 157 -345 ml and 26.6 -70.8 ml/cm H2O;50% TVRs forQmax.p,Pdet.Qmaxand Vvoidwere 5.5 -9.0 ml/s,57 -92 cm H2O and 167 -315 ml,respectively.Qmaxand Vvoidin free flow were 8.0 -9.2 ml/s and 167 -301 ml.During and after voiding,3 typical errors were found:typeⅣ:negative Pabd;typeⅤ: Pvesand Pdetafter voiding still high;typeⅥ:Pvesand Pdetnegative;the inci-dences of typesⅣ,Ⅴ andⅥ errors were 0.7%(4/582), 1.9%(11/582)and 1.4%(8/582), respective-ly. Conclusions TVRs in urodynamics are indispensable and effective tools for quantitative plausiblecheck and quality control on data.They are sensitive and reliable indicators for correct measurement and arelevant contribution to a collection of normal values.
ABSTRACT
Objective To establish and recognize typical signal patterns (TSP) by analyzing cys-tometry data,and to verify their roles in real-time qualitative quality control. Methods Totally,582 datasets of free flow,filling and voiding cystometry from181 males(age range,43 -86 years)in a strictly quality-controlled study were analyzed.TSPs for the traces of Pves,Pabdand Pdetduring filling and voiding phases wererecognized and described. The TSP of pressures was classified into 4 types, ie, type Ⅰ: fine structure(noise);Ⅱ:minimal dynamic changes caused by breathing,talking and moving (microscopic changes);Ⅲ:major changes due to regular cough tests;Ⅳ:typical macroscopic changes related to straining,detrusor insta-bility,rectal contractions and detrusor contractions.TSPs were compared among Pves,Pabdand Pdettracings atbeginning of filling,during filling,before,during and after voiding respectively. Results At beginning offilling,91.8%(534/582) of traces showed the identical fine structure and microscopic changes with“live”signals;74.8%(435/582) of traces had the equal pressure changes corresponding to the test-coughs;3.1%(18/582) had the macroscopic changes of straining and rectal contractions.During filling,98.3%(572/582) of traces showed the identicalⅠ andⅡ types of TSP;98.5%(573/582) had the equal or similarchanges corresponding to the test-coughs;8.3%(48/582) of traces showed straining;33.7% (196/582)showed detrusor instability;and 17.4%(101/582),rectal contractions.Before voiding,94.0%(547/582) oftraces had the equal rises in Pvesand Pabdcorresponding to cough tests.During voiding,91.2%(531/582) oftraces showed the“live”signals;95.2%(554/582) of traces had the typical pattern of detrusor contraction;53.3%(310/582) showed straining,2.1%(12/582) showed rectal contractions;and 15.3%(89/582)showed relaxation of pelvic floor.After voiding,91.2%(531/582) of traces showed the“live”signals;87.5%(509/582) had the equal response to cough tests. Conclusions TSP is a powerful tool for the re-al-time qualitative quality control for urodynamic investigation.Combined with typical value ranges,they allowdefinitive quality control for urodynamic data.The familiarity and identification for the described TSP arehelpful for performing the qualitative quality control in clinical urodynamic practice.