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Dear Editor, We would like to congratulate Suskind and Smith on their article on “Evidence of a Functional Effect of Transient Transurethral Catheterization on Micturition in Women,” and we agree with their conclusion, from the only analysis of urodynamic parameters of free uroflow, of the functional effect of transient transurethral catheterization on micturition in women [1]. Our main concern is that results are only based on change in uroflow curve pattern and of Qave value. If the geometric obstructive effect of an in situ catheter is not arguable because of a reduced cross section of the flow, the persistent residual obstructive effect on a free flow, after the catheter has been removed, has been little studied. We think that we can offer some arguments. In a preliminary study [2], we analyzed the effect of a urethral catheter during intubated flow that followed a free uroflow, and we proposed the occurrence of a compression-like effect of the urethra; this would explain a greater decrease in Qmax than expected by the geometric effect of the catheter. More recently [3], using the value–belief–norm (VBN) model for a careful analysis of tracings, we concluded that the cause of this additional effect (observed in 62 % of our population-positive group) was a residual excitation of the sphincter. In addition, the phenomenon (observed during intubated flow) could remain the same (condition observed in 31 % of the positive group) during free uroflow after catheter removal. Thus, as the authors concluded, the transient catheterization has a more complex impact than expected.

Functional effect of transient transurethral catheterization on micturition in women: comment