Biomedical subjects

M Virseda Chamorro

Publications and source records attributed to M Virseda Chamorro.

At least 19 recordsLinked to original sources

PubMed2006

[Assessment of effectiveness and security of bladder neck cerclage after transvesical prostatectomy].

INTRODUCTION: The Bladder neck cerclage diminishes the risk of bleeding after transvesical prostatectomy, but it increases the risk of suffering postoperative bladder neck sclerosis. Our objective is to value the effectiveness and therapeutic security of the temporary bladder neck cerclage after transvesical prostatectomy. MATERIAL AND METHODS: It was carried out a prospective and longitudinal study in a cohort of 25 age patients mean age 68,5 years (standard deviation, 2,6 years), subjected to transvesical prostatectomy (Freyer) with bladder neck cerclage using polipropilene number 1 suture, that was retired at the 24 hours of the surgery. To value the hemostatic utility of bladder neck cerclage, it was measured the hematocrit and hemoglobin concentration at the 24 hours of the intervention. To evaluate the appearance of obstructive sequels, the maximum urinary flow was measured three months after the surgery. RESULTS: It was observed a mean hematocrit at the 24 hours of surgery of 7,3%, and a mean decrease of the hemoglobin at the 24 hours of the surgery of 2,7 gr/dl. In any cases the postoperative hemoglobin concentration was inferior to 8 mg/dl, therefore, it was not necessary transfusion. The uroflowmetry carried out at 3 months of surgery showed that 24 of the 25 intervened patients presented a maximum flow superior to 15 ml/sg. CONCLUSIONS: The temporary bladder neck cerclage is a good hemostatic technique. The precocious cercalge retreat avoids the late sequels (bladder neck sclerosos), that originates the permanent cerclage.

Aged↗

PubMed2005

[Testicular neoplasms. Evaluation of the experience during 25 years in a military hospital].

OBJECTIVES: The testicular tumors are frequent in the young adult, coinciding with the incorporation to the Military Service. The objective of our work is to evaluate the tumoral characteristic, its evolution with the time and the result of the treatments used in our center for this type of tumors. MATERIAL AND METHODS: We carried out a retrospective longitudinal study in a cohort of 98 patients with an average age of 28.6 years, subjected to orchiectomy for testicular tumor in our center between 1979 to 2004. In the study, we collected data referred to the age of the patients, the tumoral characteristic, the outcome of the treatment and the evolution of the tumor. RESULTS: In 61% of the cases, the affected testicle was the right (significant differences). The most common histologyc type was the non seminomatous germ cell tumors (NSGCT) (65.3%). Followed by the pure seminomas (27.6%), and non germinal cell tumors (NGC) (7.1%). The NSGCT was diagnosed to a average age (23.2 years) significantly smaller that the other two types. The stage I was the most frequent (58%). The seminomas presented a stage I in a significantly bigger frequency (80%) that the others tumors. The data picked up during the 25 years didn't show a significant variation regarding the tumoral characteristic. The survival análisis indicated that the tumoral characteristic with better pronostic regarding the probability of tumoral recurrences were the seminomas and the tumoral stages I and II. CONCLUSIONS: The non seminomatous germ cell tumors (NSGCT) are the most frequent testicular tumors in young adults. Most of the tumors are diagnosed in initial stages, and their pronostic is better in the case of the seminomas and in the stages I and II.

Adult↗

PubMed2004

[Experimental study of the expression of the bladder wall proteins in bladder outlet obstruction in the rabbit].

OBJECTIVES: To determine the relationship of the bladder wall levels of the contractile proteins: whole actin, beta-actin, alpha-sarcomeric-actina caldesmon and of the Heat Stress Protein HSP-70, with the partial bladder outlet obstruction. MATERIAL AND METHODS: It was carried out an experimental study on 43 New-Zealand rabbits. These animals were divided into a control group and six experimental groups with partial bladder outlet obstruction induced by an incomplete tie around the urethra. The experimental groups were defined according the day when the animals were sacrified: at 24 hours, 7 days, 15 days, 1 month, 3 months and 6 months of the obstruction. It was determined in all animals the muscular bladder wall concentration of whole actin, beta-actin, alpha-sarcomeric-actin, caldesmon and HSP-70 protein, according to Western Blotting technique. The results were analyzed by means of ANOVA, using the Scheffe post hoc method. RESULTS: The bladder weight of the obstructed animals increased significantly in two stages: until the day 15 and between the day 15 and the end of the study, corresponding to theoretical phases of initial hypertrophy and compensation. The level of whole actin showed a significant decrease at the beginning of compensation phase, while the beta-actin level increased in the phase of initial hypertrophy and the alpha-sarcomeric-actin level increased at the end of the compensation phase, while the caldesmon and the HSP-70 made it at the end of the initial hypertrophy phase. CONCLUSIONS: Analysing our data we conclued that the determination of the caldesmon levels is the marker that better adjusts to the changes associated with partial bladder outlet obstruction in the rabbit.

Actins↗

PubMed2002

[Clinical and analytical parameters that might indicate a second biopsy in patient with high PSA and previously negative biopsy].

OBJECTIVES: To determine what clinical, analytic and ultrasound parameters, are more effective to predict the result of a second biopsy in patient with high PSA and a first prostate biopsy negative. MATERIAL AND METHODS: It was carried out a longitudinal study in a series of 435 cases with negative prostate biopsy. In 59 of these cases it was practiced a second biopsy due to a permanent or sudden high PSA levels with or without a suspicious digital rectal examination. Of the 31 cases with a negative second biopsy, in 4 cases it was carried out a third biopsy. The biopsy was made in all the occasions by transrectal ultrasound guided sextant biopsy. It were also valued the ultrasound characteristic of the prostate, the prostate volume and the proportion of free PSA. RESULTS: It was demonstrated statistically significant differences among the patients with a second biopsy negative and positive regarding: the age, proportion of free PSA, abnormal digital rectal examination and presence of hipoechogenic areas in the prostate. The multivariate analysis demonstrated that the only significant parameters were the proportion of free PSA and the existence of an abnormal digital rectal examination. Based on the data of multivariate analysis, we settled down for the patients with normal digital rectal examination a cut-off point of 0.23 of proportion of free PSA as indication for the realization of a second biopsy, and of 0.59 for the patients with abnormal digital rectal examination. This protocol applied to our series would avoid the realization of a second biopsy in 8 patients, and a third biopsy in 1 patient, diagnosing all the cases of prostate cancer. CONCLUSIONS: The digital rectal examination associated with the proportion of free PSA constitutes a reliable parameter to indicate the realization of a second prostate biopsy in patient with high PSA and previous negative biopsy.

Aged↗

PubMed1999

[Reliability of fractal dimension measurement of uroflow curves].

OBJECTIVE: To determine the reliability of fractal analysis of uroflow curves. METHODS: We analyzed the correlation between the fractional dimension analysis of two series of uroflow curves with an interval of 88.21 days. The fractal dimension was calculated by two methods. RESULTS: A good correlation was found for both methods, although it was lower than that of maximum flow. A relationship was found between the fractal dimension and maximum flow. CONCLUSIONS: The fractional dimension is a reliable parameter that appears to be related with urinary flow.

Fractals↗

PubMed1999

[Diabetic neurocystopathy: multivariate study].

OBJECTIVE: To analyze the prevalence of urodynamic disorders and the factors associated with bladder instability in patients with diabetes mellitus. METHODS: We conducted a clinical and urodynamic study on 138 diabetic patients (71 males, 51%; 67 females, 49%) with a mean age of 64.04 years. Patient evaluation included patient history, neurological physical examination, cystometry, pressure-flow test, filling videocystography and selective EMG of the periurethral sphincter. Data obtained were analyzed by multivariant logistic regression analysis, taking the probability of developing bladder instability as a dependent variable. RESULTS: Bladder instability was the most frequent urodynamic finding (52%), followed by lower urinary tract obstruction (44%), involvement of bladder contractility (41%) and stress urinary incontinence (22%). Lower motor neuron (S2-S4) pudendal nerve lesion was observed in 33% of the cases and 24% had upper motor neuron involvement. Multivariant analysis showed age and stress urinary incontinence (inverse correlation) to be the only independent variables for bladder instability. The other variables that correlated with instability (but dependent on the foregoing variables) were involvement of bladder contractility and type of diabetes (higher probability for diabetes type II). No correlation was found for sex, duration of the diabetes, stroke (CVA), urinary obstruction or pudendal nerve lesion. CONCLUSIONS: Bladder instability was found to be the most frequent urodynamic disorder in diabetic patients. The probability of developing bladder instability increases with age and decreases in patients with stress urinary incontinence.

Adult↗

PubMed1999

[The clinical and flowmetric results of the treatment of benign prostatic hyperplasia with doxazosin].

OBJECTIVE: To evaluate the clinical efficacy of doxazosin for 6 months in the treatment of benign prostatic hyperplasia (BPH). METHODS: A prospective clinical and uroflowmetric study was conducted on 65 males with BPH treated with doxazosin 4 mg daily for 6 months. Patient mean age was 66.7 years (range 45-79). Clinical evaluation (IPSS and andrologic data) and blood analyses were performed before and after treatment. IPSS data were obtained according to the WHO validation and Spanish translation. RESULTS: A significant improvement was found between the mean pre- and post-treatment IPSS scores (19.8 +/- 4.8 vs 11.9 +/- 4.6; p < 0.001). Maximum flow rate before treatment was 9.13 ml/sec, which increased to 16.23 ml/sec after treatment (p < 0.001). Postvoid residual urine dropped from 21.7% to 12.5% (p < 0.01). All the patients were normotensive before (135.9 mean systolic and 78.9 mean diastolic blood pressure) and after treatment (135.4 mean systolic and 77.8 mean diastolic blood pressure). Mean heart rate was similar before and after treatment (71.9 +/- 5.8 vs 71.8 +/- 5.9). A relationship between low IPSS score before treatment and urinary symptoms improvement was demonstrated (coeff. -0.45939). No relationship was found between prostate volume (digital rectal examination or transabdominal ultrasound) and improvement in the IPSS score. No statistical relationship was found between the IPSS and postvoid residual urine or peak flow. No modifications of sexual activity was demonstrated with doxazosin treatment. Pre- and post-treatment blood analytical data fell within the normal ranges. Transient side effects were observed in 12 patients (20%): headache in 6 patients (10%), fatigue in 6 (10%), dizziness in 3 (5%) and somnolence in (5%). CONCLUSIONS: Doxazosin, at a daily dose of 4 mg daily for 6 months, is a safe and effective treatment in patients with BPH.

Adrenergic alpha-Antagonists↗

PubMed1998

[Urodynamics of urinary incontinence post radical prostatectomy].

OBJECTIVE: To determine the urodynamic characteristics of urinary incontinence after radical retropubic prostatectomy. METHODS: We conducted a clinical and urodynamic study on 25 patients who had undergone radical retropubic prostatectomy due to localized prostate adenocarcinoma. RESULTS: 68% of the patients completely recovered urinary continence. The maximum rate of urinary continence recovery was found between the third and fourth month postprostatectomy. A relationship was demonstrated between preoperative hormone blockade, duration of the surgery and urinary continence. Videocystography demonstrated an incompetent proximal continence mechanism in all radical prostatectomy patients. All incontinent patients presented stress urinary incontinence. Denervation potentials of the periurethral sphincter was demonstrated by electromyography in 80% of incontinent patients. These potentials were not present in the continent patients. Reinnervation potentials were present in 50% of the continent patients and in 20% of the incontinent patients (significant differences). No relationship was found between other urodynamic data and post-radical prostatectomy urinary incontinence. CONCLUSIONS: The surgical difficulty influences the preservation of urinary continence. A high percentage of patients submitted to radical prostatectomy recover urinary continence with time. Urinary incontinence following radical prostatectomy is based on the distal sphincteric mechanism. Patients who remain incontinent four months postoperatively and with electromyographically demonstrated denervation potentials of the periurethral sphincter can be considered to be candidates for treatment of incontinence without waiting any further.

Aged↗

PubMed1997

[The doxazosin treatment of the changes in the bladder filling phase in benign prostatic hyperplasia].

OBJECTIVE: To analyze the clinical and urodynamic efficacy of treatment with doxazosin during 6 months for bladder filling phase disorders in patients with BPH. METHODS: A prospective clinical and urodynamic study was performed in 65 males with BPH, aged 54-79 years (mean 66.7), who had been treated with doxazosin (4 mg/day) during 6 months. Clinical [International Prostatic Symptom Score (IPSS)] and urodynamic evaluations (cystometry and filling cystography) before and after treatment were performed. IPSS data were obtained according to the WHO recommendation following validation and translation into Spanish. RESULTS: The IPSS score improved significantly from 19.8 +/- 4.8 before treatment to 11.9 +/- 4.6 after treatment (p < 0.001). All the patients were normotensive before and after treatment (systolic and diastolic blood pressures 135.9/78.9 and 135.4/77.8 mmHg, respectively). No tachycardia was observed before (71.9 +/- 5.8) or after treatment (71.8 +/- 5.9). A relationship between the lower IPSS before treatment and urinary symptoms improvement was demonstrated (coef.-0.45939). We found no relationship between prostate volume (digital rectal examination or transabdominal ultrasonography) and IPSS modifications after treatment. Bladder instability decreased significantly from 71.6% before treatment to 33.3% after treatment (p < 0.01). Instability pressure also diminished from 99.2 cms H2O to 60.3 cms H2O after doxazosin treatment (p < 0.001). We found no significant relationship between IPSS and bladder instability post-treatment. CONCLUSIONS: Adrenergic blockade with doxazosin 4 mg/day for 6 months achieves a significant decrease in the bladder instability associated with prostatic obstruction in patients with BPH, although no statistical correlation with the IPSS could be demonstrated.

Adrenergic alpha-Antagonists↗

PubMed1997

[Doxazosin treatment of disorders of the voiding phase in benign prostatic hyperplasia].

OBJECTIVE: To analyze the clinical and urodynamic efficacy of treatment with doxazosin during 6 months for voiding phase disorders in patients with BPH. METHODS: A prospective clinical and urodynamic study (before and after treatment) was performed in 65 consecutive male patients with BPH, aged 54-79 years (mean 66.7), to evaluate the results of treatment with doxazosin 4 mg/day during 6 months. Clinical evaluation included patient history and the International Prostatic Symptom Score (IPSS) and urodynamic evaluation included uroflowmetry with post-void residual data and pressure-flow test. A static urethral pressure profile was associated with the urodynamic voiding study. RESULTS: The IPSS score improved significantly from 19.8 +/- 4.8 before treatment to 11.9 +/- 4.6 after treatment (p < 0.001). Urinary symptoms improved significantly more markedly after treatment (coeff. -0.45939) in patients with a lower IPSS score. The symptomatic improvement demonstrated by the IPSS did not correlate with the DRE or the transabdominal US prostatic volume. Mean maximum flow rate before treatment was 9.13 ml/sec and increased to 16.23 ml/sec after treatment (p < 0.01). Postvoid residual dropped from 21.7% to 12.5% (p < 0.01). In the pressure-flow test, foot-point PURR dropped significantly from 69 cms H2O to 45.9 cms H2O (p < 0.001). The PURR curvature diminished from 0.27416 to 0.15964 cms H2O (ml/sec2) (p < 0.01). A statistically significant improvement of the compressive (p < 0.001) and constrictive (p < 0.05) elements of lower urinary tract obstruction was observed. The urethral functional length of the urethral profile showed a significant reduction (pre-treatment: 5.56 cms; post-treatment 4.31 cms) (p < 0.05). A statistical correlation was found between the urethral functional length and the foot-point PURR post-treatment. CONCLUSIONS: Adrenergic blockade with doxazosin reduces both the compressive and constrictive elements of lower urinary tract obstruction in the voiding phase in patients with BPH, although no statistical correlation with the IPSS could be demonstrated.

Adrenergic alpha-Antagonists↗

PubMed1996

[Usefulness of DURR (dynamic urethral resistance factor) in the study of prostatism].

OBJECTIVES: To determine the utility of the DURR (dynamic urethral resistance factor) in the evaluation of prostatism. METHODS: 248 patients with prostatism were evaluated by the detrusor pressure-flow rate test, perineal and periurethral EMG and voiding videocystography. The Audit software program was utilized to process the data from the pressure-flow studies to obtain the parameters for urethral resistance (PURR), bladder contractibility (Wmax) and DURR. RESULTS: The presence of DURR correlated significantly with abdominal voiding pressure and voluntary voiding, and constrictive obstruction, although a higher incidence of stenosis in patients with a positive DURR was not demonstrable on videocystography. No correlation was observed between EMG activity and a positive DURR. CONCLUSIONS: A positive DURR indicates the effect of active urethral resistance changes on the voiding dynamics. These active changes can be caused by contraction of the periurethral muscles (EMG activity), although not all of the cases showing EMG activity have a positive DURR. Furthermore, in some DURR positive cases, the EMG is silent, indicating that the urethral smooth muscles are involved in the active changes of urethral resistance. The DURR data do not always coincide with the perineal EMG findings and therefore do not supplant each other.

Aged↗

PubMed1996

[Results of electric stimulation in the treatment of post-prostatectomy urinary incontinence].

Clinical and urodynamic studies were conducted in 19 patients undergoing intrarectal electrostimulation due to post-prostatectomy urinary incontinence. It was corroborated that patients referring incontinence with isolated coughing presented better clinical outcome (80% positive results) than those who also referred urgency-incontinence (44%). Patients with stress incontinence showed positive clinical results post-stimulation in 78% cases. Patients with vesical instability, in 40% cases and patients with mixed incontinence, in 60%. In contrast, elimination of vesical instability was urodynamically proven in 60% cases, but in only 22% with stress incontinence. In mixed incontinence (instability + stress) the instability persisted only in 20% while stress incontinence persisted in 80% cases. The above data would advocate electric stimulation as a therapeutical alternative in post-prostatectomy urinary incontinence.

Aged↗

PubMed1996

[Clinical results of the treatment of urinary incontinence with peripheral electric stimulation].

A series of 126 patients, 98 women (78%) and 29 male (22%), average 50.2 years old, with different types of urinary incontinence (incontinence at cough, urge-incontinence, post-prostatectomy incontinence and nocturnal enuresis), has been treated with periferic electrostimulation to evaluate the clinical value of this type of treatment. Extrahospitalary management with electrostimulation by vaginal in 39 cases (30.9%) or rectal in 87 cases (69.1%) electrodes was performed. Frequencies has been different in urge-incontinence (10 Hz) and urinary incontinence at coughing (50 Hz). Average treatment duration was 3.3 months. Incontinence intensity decreased significantly with electrostimulation treatment (51-62%). Non statistical differences between other parameters (age, sex, clinical features, clinical incompetence type, cistocele grade) was observed. Positive results in larger period treatment (over 3 months) was obtained (p < 0.005). Best results were obtained with 10 Hz and 50 Hz frequencies (p < 0.05). Therapeutic results, good tolerance (89%), easy application for the patient and absence of secondary effects could made electrostimulation as an alternative therapy in all type of urinary incontinence.

Adolescent↗

PubMed1996

[Urodynamic results of the treatment of urinary incontinence with peripheral electric stimulation].

OBJECTIVES: To evaluate the urodynamic results achieved by electrostimulation in patients with different types of urinary incontinence. METHODS: 37 patients (32 females and 5 males) with urinary incontinence were treated with peripheral electrical stimulation. The urodynamic diagnosis were: detrusor instability (24.3%), stress urinary incontinence (24.3%), mixed urinary incontinence (48.6%), and bladder hyper-reflexia (2.7%). Rectal and vaginal electrodes were utilized. The therapeutic frequencies were 10 Hz, 20 Hz and 50 Hz. RESULTS: Detrusor instability disappeared in the cases treated with the 10 Hz frequency (79%) and in one case treated with the 50 Hz frequency. A significantly increased bladder capacity and decreased first micturition sensation were observed in this patient group. All patients with stress urinary incontinence were treated with high frequency (50 Hz), which achieved positive results in 44%. In the group of patients with mixed urinary incontinence. 45% remained unchanged. Treatment failed to achieve satisfactory results in the single case of detrusor hyperreflexia in this series. CONCLUSION: Peripheral electrical stimulation is a valid alternative in the treatment of male and female incontinence. Satisfactory results were achieved with the 10 Hz frequency in 89% of the patients with bladder instability and with the 50 Hz frequency in 44% of the patients with stress urinary incontinence.

Adult↗

PubMed1996

[The need for an adequate urodynamic study in the assessment of stress urinary incontinence following urethropexis].

OBJECTIVES: To determine the utility of the urethral pressure profile and videocystography in the evaluation of stress urinary incontinence posturethropexy. METHODS: A clinical, urodynamic and radiological study was conducted in 50 females who had undergone urethropexy due to stress urinary incontinence. The clinical features and urodynamic demonstration of urinary incontinence were analyzed and the type of incontinence was evaluated by videocystography and the urethral pressure profile posturethropexy. RESULTS: The urethral pressures did not correlate with the clinical findings or urodynamic demonstration of urinary incontinence posturethropexy. A maximum urethral pressure significantly lower in patients with radiologically demonstrated type III incontinence was observed. The presence of an open bladder neck, although significantly more frequent in patients with type III urinary incontinence, showed no correlation with the demonstration of urinary incontinence. An open bladder neck was also observed in patients with type II incontinence and patients who were continent posturethropexy. CONCLUSIONS: To determine the type of urinary incontinence posturethropexy, it is necessary to utilize cystomanometry, filling videocystography and urethral pressure profile.

Adult↗

PubMed1995

[Effects of urethropexy on urination. A price to pay?].

OBJECTIVES: To evaluate the voiding repercussions of urethropexy. METHODS: We carried out a clinical and urodynamic study in 70 patients subjected to different techniques of urethropexy (Kelly, Raz, Marshall-Marchetti-Krantz, Burch and simplified Ramirez) for stress urinary incontinence. We evaluated the voiding repercussions of urethropexy. RESULTS: There was a significant increase in the obstructive symptoms with urethropexy (29% of the patients) although there was no relationship with the variation of the urinary flow rate. It also significantly diminished the urinary flow rate (85% of the patients) and increased the postvoiding volume significantly (3.68 times the average before surgery). The increase in postvoiding volume occurred more frequently in patients with diminished urinary flow rate before urethropexy (60% of the cases). The Raz technique showed less urodynamic data of voiding disturbances. CONCLUSIONS: Urethropexy causes voiding disturbance. We believe the decrease in urinary flow rate is related to the increase in urethral resistance produced by urethropexy. In the cases with previously diminished urinary flow rate, reduction in bladder contractility is added to the former mechanism.

Adult↗

PubMed1995

[Clinical, urodynamic, and radiologic results in the study of prostatism with the PURR measure (passive urethral resistance ratio)].

OBJECTIVE: The present study was conducted to determine the correlation between the urinary symptoms and lower urinary tract dynamics in patients with prostatism. METHODS: 105 males with prostatism (mean 66.19 years) were evaluated clinically, urodynamically and radiologically by PURR (passive urethral resistance ratio) determination. RESULTS: The intensity of the irritative symptoms was slightly higher (21%) when bladder instability was associated. The obstructive symptoms were associated with diminished urinary flow rate and could be observed in bladder outlet obstruction (81%) or diminished bladder contractility (79%). Both conditions were found in 49% of the cases. The postvoiding urine depended on diminished bladder contractility (37%), but not on bladder outlet obstruction. Bladder instability did not depend on obstruction, although 88% of the patients with unstable bladder were obstructed. Compressive obstruction was associated with a lesser degree of diminished contractility (55%) than the other forms of obstruction. Prostatism was associated with diminished contractility without bladder outlet obstruction in 15% of the cases. The irregular bladder was more frequent in bladder outlet obstruction (92%) and bladder diverticula were more frequent in bladder instability (36%). In all the cases with compression and lengthening of the prostatic urethra, the diagnosis was compressive obstruction. In all the cases with segmental, diminished urethral diameter, the diagnosis was obstruction, although only 30% were diagnosed as constrictive compression. No pathological urethral changes were demonstrable on cystourethrography in 33% of the cases with obstruction. CONCLUSIONS: Urinary symptoms correlate poorly with lower urinary tract dynamics. PURR determination is a very reliable method of diagnosis in urinary obstruction, for both segmentally diminished and more extensive involvement (elongation and compression of the prostatic urethra) of the urethral lumen.

Adult↗

PubMed1995

[A comparative study of different urodynamic methods used in the diagnosis of lower urinary tract obstruction in men].

OBJECTIVES: The present study compared the results of the different urodynamic methods utilized in the diagnosis of urinary obstruction. METHODS: A urodynamic study was performed in 105 patients with prostatism; mean age 66.19 years. The following five urodynamic methods were utilized: maximum pressure/maximum flow rate (Pmax/Fmax), pressure/flow nomogram, pressure/flow curve, Schaefer's PURR and the resistance square. RESULTS: The Pmax/Fmax method showed the lowest percentage of obstruction (61%), 48% of the nomograms were inconclusive, the pressure/flow curve diagnosed obstruction in 88%, Schaefer's PURR diagnosed obstruction in 77% and the resistance square diagnosed obstruction in 78% of the cases. When the nomogram findings were diagnostic, no significant differences between the other methods were observed. The Pmax/Fmax, pressure/flow curve and the PURR methods proved to be independent methods, while the resistance square showed no significant differences with Schaefer's PURR. An irregular bladder at cystography was associated with a significantly higher percentage of obstruction (72% vs 92%). Lengthening and compression of the prostatic urethra demonstrable on cystourethrography was associated with the diagnosis of obstruction on all the methods used. A diminished segment of the urethral lumen was associated with a high percentage of obstruction on all methods, the PURR showing the highest (100%). However, the diagnosis of constrictive obstruction was found in only 30% of the cases.

Adult↗