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Influence of intravesical potassium on pelvic floor activity in women with recurrent urinary tract infections: comparative urodynamics might lead to enhanced detection of dysfunctional voiding
Author(s) -
Akkad Thomas,
Pelzer Alexandre E.,
Mitterberger Michael,
Rehder Peter,
Leonhartsberger Nicolai,
Bartsch Georg,
Strasser Hannes
Publication year - 2007
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2007.07120.x
Subject(s) - urinary system , urology , medicine , pelvic floor , pelvic floor disorders , lead (geology) , dysfunctional family , urinary incontinence , surgery , biology , paleontology , clinical psychology
Authors from Austria present their 1‐year follow‐up of 117 patients with stress urinary incontinence treated with autologous myoblasts and fibroblasts obtained from skeletal muscle biopsies. This detailed study shows that such a procedure is highly effective and safe for treating this condition. OBJECTIVES To investigate the influence of intravesical potassium on pelvic floor activity (PFA) during voiding in women with recurrent urinary tract infections (rUTIs) by using comparative urodynamics (CUD). PATIENTS AND METHODS CUD was conducted in 49 women (mean age 34.6 years, range 15–82) with rUTI. Every patient had two sessions of pressure‐flow studies with simultaneous measurement of PFA by perineal surface electromyography (EMG); the first was with 0.9% saline and in the second the bladder was filled with 0.2 m KCl solution. All patients had voiding cysto‐urethrography, and dysfunctional voiding (DV) was diagnosed when significant PFA was measured by EMG during voiding. RESULTS Overall, DV was diagnosed in 37 patients (76%) using CUD; 16 (32%) had DV with saline on the pelvic floor EMG. In all these patients there were significantly greater EMG signals in the presence of KCL. In 21 patients (43%) DV was only detected using KCL; this improvement in the detection rate of DV was statistically significant ( P = 0.006). Filling with KCl also prompted a statistically significant difference ( P < 0.05) in maximum bladder capacity, maximum and average flow rates and in postvoid residual urine volume. CONCLUSION The present data show that DV is present in most women with rUTI but cannot sufficiently be diagnosed by conventional urodynamics with standard 0.9% saline. The present study suggests that CUD might enhance the detection rates of DV.