[Urodynamics and uterine fibroid. Is there a specific parameter?]. / Urodynamique et fibrome utérin. Existe-t-il un paramètre spécifique?

AIM OF STUDY: To search for a urodymamical parameter and/or a VBN parameter (deduced from a modelized analysis of uroflows) which could characterize the voiding dysfunctions due to a uterine fibroid. POPULATION AND METHODS: Thirty women (31-69 years) with a uterine fibroid (exclusion criteria: neurological disease, diabetes mellitus, previous pelvic surgery, grade > I prolapse) underwent one urodynamic session which included the successive tests: free uroflow, urethral profilometry, cystometry and, if possible, a second free uroflow. Twenty-eight patients complained from stress urinary incontinence. Modelized analysis of the flow curves was performed in order to determine the value of two VBN parameters: urethral parameter g and recruitment ratio rr (which quantify the ratio of firing motor neurons during detrusor contraction). RESULTS: The fibroid (known for 23 subjects) was detected during gynaecological examination in seven cases. No significant change of the value of one urodynamical parameter which could be linked to the uterine fibroid rather than the urinary disorder has been found. Some urethral constrictive obstruction exists for 18 patients (g = 0.40 +/- 0.15) but is not meaningful. In the whole population, an effective abdominal pressure is found in 78% of the analyzed micturitions. CONCLUSION: Some urinary disorders result from the presence of a uterine fibroid; they are significantly improved by simple hysterectomy. If urodynamics does not have any specificity, concomitant physical examination allows to detect fibroids with only urinary symptomatology.

[Are age and urodynamic data correlated in women with stress urinary incontinence (SUI)?]. / Existe-t-il une corrélation entre l'âge et les données du bilan urodynamique chez la femme présentant une incontinence urinaire d'effort (IUE)?

PURPOSE: Our aim was to evaluate the impact of age on lower urinary tract function in women by means of urodynamics and modelized analysis of the recorded free uroflow curves. MATERIAL AND METHODS: One hundred and fifty three women (age range: [30-93 years]; 6 decades A to F) with only SUI complaint underwent a urodynamic evaluation which included initial free uroflow, urethral pressure profile, cystometry and final free uroflow at bladder functional capacity. Modelized analysis was performed using the VBN mathematical micturition model; from comparison between recorded and computerized theoretical flow curves this model allows to determine two characteristic parameters: one of urethral obstruction and one of detrusor efficiency. RESULTS: No age-related changes were found in bladder capacity, peak flow rate in the first void and post residual volume. A significant increase of peak flow rate was noted in the second void for D and older. Bladder compliance decreased only from E. As usually described a decrease with age of the maximum urethral closure pressure occurred while the functional urethral length decreased only from E. A flat distribution of the VBN parameters was observed. DISCUSSION-CONCLUSION: This study shows the absence of age-associated changes in both urodynamic data and VBN parameters in a population of women with SUI and without any other disease. These findings reinforce the idea that chronological age does not strongly correlate with the physiological status.