Urodynamic quality control (PartⅡ):recognition of typical signal pattern and its role in real-timequalitative quality control / 中华泌尿外科杂志

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.