ABSTRACT
AIMS: Air-charged (AC) and water-perfused (WP) catheters have been evaluated for differences in measuring pressures for voiding dysfunction. Typically, a two-catheter system was used. We believe that simultaneous pressure measurements with AC and WP in a single catheter will provide analogous pressures for coughs, Valsalvas, and maximum pressures in voiding pressure studies (VPS). METHODS: This IRB approved prospective study included 50 women over age 21. AC dual TDOC catheters were utilized. The water-filling channel served as the bladder filler and the water pressure readings. Patients were evaluated with empty bladders and at volumes of 50-100 mL, 200 mL, and maximum capacity with cough and Valsalva maneuvers. Comparative analysis was performed on maximum stress peak pressures. At maximum bladder capacity, VPS was done and maximum voiding pressure was recorded. RESULTS: Comparing coughs and Valsalva maneuvers pressures, there was significant increase in variability between AC and WP measurements with less than 50 mL volume (P < 0.001). Significant correlations were observed between AC and WP measurements for coughs and Valsalvas with bladder volume over 50 mL. Visual impression showed virtually identical tracings. Cough measurements had an average difference of 0.25 cmH2 O (±8.81) and Valsalva measurements had an average difference of 3.15 cmH2 O (±4.72). Thirty-eight women had usable maximum voiding pressure measurements and had a strong correlation. CONCLUSIONS: Cystometrogram and maximum voiding pressure measurements done with either water or air charged catheters will yield similarly accurate results and are comparable. Results suggest more variability at low bladder volumes <50 mL.
Subject(s)
Catheters , Diagnostic Techniques, Urological , Urinary Bladder/physiopathology , Urination/physiology , Adult , Aged , Cough/physiopathology , Female , Humans , Hydrostatic Pressure , Middle Aged , Pressure , Prospective Studies , Urodynamics , Valsalva Maneuver , WaterABSTRACT
Female Sexual Dysfunction (FSD) is a complex biopsychosocial phenomenon. Screening, identifying and managing urogenital and sexual symptoms often result in significant improvement in women's quality of life. Providers must proactively question patients about possible presence of FSD. When a sexual problem is present, identify the type of FSD, counsel patients on the appropriate approaches to treatment. No single therapeutic approach is effective in treating all types of FSD.
Subject(s)
Dyspareunia , Vulvodynia , Cystitis, Interstitial/diagnosis , Dyspareunia/physiopathology , Dyspareunia/psychology , Female , Humans , Pelvic Floor/physiopathology , Pelvic Floor Disorders/physiopathology , Pelvic Floor Disorders/therapy , Physical Examination , Quality of Life , Vulvodynia/diagnosis , Vulvodynia/etiology , Vulvodynia/physiopathology , Vulvodynia/psychology , Vulvodynia/therapyABSTRACT
This article examines the social and physical causes of obstetric fistulas, as well as resulting social and psychological consequences. Preventative strategies are addressed using Niger as a microcosm for this devastating condition that affects two million women worldwide.
