[Evaluation of the irrigation and drainage capacity of 3 bladder irrigation catheters]. / Evaluación de la capacidad de irrigación y drenaje de tres sondas de lavado vesical.

OBJECTIVES: To perform a comparative evaluation of three types of continuous bladder irrigation catheters with the aim of determining which of them allows greater irrigation solution inflow and bladder outflow. METHODS: We compared three types of three-way catheters, 22F in caliber, being the material the main difference between them: latex, silicone, or polyvinyl. RESULTS: The polyvinyl catheter showed significant differences both in inflow and outflow in comparison with the other two types of catheters (p = 0.000, ANOVA test with Sheffe's post hoc). Additionally, the latex catheter showed a significant outflow decrease with the insufflation of the self retentive balloon. CONCLUSIONS: The polyvinyl catheter, due to material rigidity, is the one that allows better bladder irrigation.

[The usefulness of clinical history for the diagnosis of lower urinary tract obstruction in patients with acute urinary retention]. / Utilidad de la historia clínica para el diagnóstico de obstrucción del tracto urinario inferior en pacientes con retención aguda de orina.

OBJECTIVES: To determine the diagnostic usefulness of data provided by clinical history for the diagnosis of lower urinary tract obstruction in patients with acute urinary retention. METHODS: We performed a transversal study in a series of 70 patients (19 women and 51 men) with a mean age of 61.5 years (typical deviation 20.7 years), who underwent urodynamic study due to acute urinary retention. Past medical history was recorded in all patients. Physical exam was also carried out, evaluating prostate size in males, presence of genital prolapse in females, and neurourological examination. Urodynamic tests consisted on flowmetry, pressure/flow studies with simultaneous perineal electromyography, and voiding cystourethrogram or videocystogram. Student's t mean comparison and chi-square tests were used for the statistical analysis. RESULTS: The only clinical data that showed a statistically significant relationship with obstruction of the lower urinary tract were: age, sex, prostate size, and existence of infrasacral neurological lesion (absence of bulbocavernous reflex). Age > 74 years showed a sensitivity of 71 % for lower urinary tract obstruction and a specificity of 60%. Male sex showed a sensitivity of 88% and specificity of 36%. Prostate size > or ='3d grade II sensitivity was 58% and specificity 82%; and absence of infrasacral lesion a sensitivity of 77% and specificity of 48%. CONCLUSIONS: Provided that a negative result in a test with high sensitivity makes the likelihood of disease low, in women the presence of infrasacral neurogenic dysfunction or age < or ='3d74 years diminish the probability of obstruction in patients with acute urinary retention. On the other side, if a negative result of a test with high specificity increases the probability of having the disease, a prostate size > or ='3d grade II and age > 74 years favour the likelihood of having urinary tract obstruction for a patient with acute urinary retention.

Utilidad de la historia clínica para el diagnóstico de obstrucción del tracto urinario inferior en pacientes con retención aguda de orina / The usefulness of clinical history for the diagnosis of lower urinary tract obstruction in patients with acute urinary retention

OBJETIVO: Determinar la utilidad diagnósticade los datos aportados por la historia clínicapara el diagnóstico de obstrucción del tracto urinarioinferior (OTUI) en los pacientes con retención aguda deorina (RAO).MÉTODOS: Se realizó un estudio transversal en unaserie de 70 pacientes (19 mujeres y 51 varones) deedad media 61, 5 años (desviación típica 20,7 años),sometidos a estudio urodinámico por presentar RAO.Los pacientes fueron interrogados sobre sus antecedentespatológicos. Se les realizó además una exploraciónclínica, valorando el tamaño prostático en varones, presenciade prolapsos genitales en mujeres, y una exploraciónneurourológica. El estudio urodinámico consistióen una flujometría libre, un estudio de presión/ flujocon registro simultaneo de la actividad electromiográficaperineal, y una cistografía o videocistografía mic-cionales. La pruebas estadísticas utilizadas fueron el testde comparación de medias de la t de Student y el testde la Chi-cuadrado.RESULTADOS: Los únicos datos clínicos que mostraronuna relación estadísticamente significativa con la OTUIfueron: la edad, el sexo, el tamaño prostático y la presenciade lesión neurológica infrasacral (ausencia delreflejo bulbocavernoso). Los pacientes con edad superiora 74 años presentaron una sensibilidad respecto ala presencia de OTUI del 71% y una especificidad del60%. El sexo masculino mostró una sensibilidad del88% y una especificidad del 36%. El tamaño prostáticosuperior o igual a un grado II, una sensibilidad del58% y una especificidad del 82%, y la ausencia delesión infrasacral una sensibilidad del 77% y una especificidaddel 48%.CONCLUSIONES: Dado que, un resultado negativoen una prueba con una alta sensibilidad, hace pocoprobable la presencia de la enfermedad, en el sexofemenino, la presencia de una disfunción neurógenainfrasacral y una edad menor o igual a 74 años, disminuyenla probabilidad de obstrucción en pacientescon RAO. Por otra parte, como un resultado negativopara una prueba con una alta especificidad, aumentala probabilidad de padecer la enfermedad; una próstatade tamaño mayor o igual a un grado II y una edadsuperior a los 74 años, favorecen la probabilidad depadecer obstrucción urinaria en un paciente con RAO

OBJECTIVES: To determine the diagnostic usefulness of data provided by clinical history for the diagnosis of lower urinary tract obstruction in patients with acute urinary retention. METHODS: We performed a transversal study in a series of 70 patients (19 women and 51 men) with a mean age of 61.5 years (typical deviation 20.7 years), who underwent urodynamic study due to acute urinary retention. Past medical history was recorded in all patients. Physical exam was also carried out, evaluating prostate size in males, presence of genital prolapse in females, and neurourological examination. Urodynamic tests consisted on flowmetry, pressure/flow studies with simultaneous perineal electromyography, and voiding cystourethrogram or videocystogram. Student’s t mean comparison and chi-square tests were used for the statistical analysis. RESULTS: The only clinical data that showed a statistically significant relationship with obstruction of the lower urinary tract were: age, sex, prostate size, and existence of infrasacral neurological lesion (absence of bulbocavernous reflex). Age > 74 years showed a sensitivity of 71% for lower urinary tract obstruction and a specificity of 60%. Male sex showed a sensitivity of 88% and specificity of 36%. Prostate size >=3d grade II sensitivity was 58% and specificity 82%; and absence of infrasacral lesion a sensitivity of 77% and specificity of 48%. CONCLUSIONS: Provided that a negative result in a test with high sensitivity makes the likelihood of disease low, in women the presence of infrasacral neurogenic dysfunction or age =3d grade II and age > 74 years favour the likelihood of having urinary tract obstruction for a patient with acute urinary retention