Non-invasive evaluation of straining during voiding
Research type
Research Study
Full title
Comparison of the reliability, acceptability and feasibility of non-invasive tests (ElectroMyoGraphy (EMG) and TocoDynamoMetry (TDM)) versus the more invasive gold standard (rectal balloon) to measure straining during voiding in male subjects.
IRAS ID
227786
Contact name
Andrew Gammie
Contact email
Sponsor organisation
North Bristol NHS Trust
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
Detrusor underactivity (DU) and bladder outlet obstruction (BOO) may present very similarly in men, with weakening or interruption of the urinary stream, difficulties initiating voiding and a sensation of incomplete emptying of the bladder. Currently, the only way to distinguish between DU and BOO is through invasive testing with pressure-flow studies (PFS), requiring catheters in both the bladder and the rectum. This can cause both patient discomfort as well complications such as urinary tract infection or hematuria. However, distinction between both conditions is important to avoid unnecessary surgical interventions (e.g. transurethral resection of the prostate for BOO may lead to limited symptomatic improvement in patients with DU, and may therefore unnecessarily expose the patient to risks).
In this study, we want to investigate the reliability, acceptability and feasibility of non-invasive tests to measure straining during voiding, as straining may distinguish patients with BOO from patients with DU (Reynard JM et al., British Journal of Urology, 1995; Gammie et al, European Urology, 2015). We shall compare electrical signals on the abdomen and also straining measurement as used during childbirth to the measurement of rectal pressure (which is the gold standard to measure straining in PFS), and investigate their reliability, acceptability and feasibility to measure abdominal strain during free (non-catheterised) uroflowmetry. We shall also test whether straining during voiding changes uroflow parameters in a different way in patients with BOO and patients with DU.
During the same protocol, we want to evaluate differences in filling sensation between patients with DU and BOO in a non-invasive way with a bladder scan. Preliminary data from analysis of PFS in patients with DU and BOO have suggested a difference in filling sensation between patients with DU and patients with BOO, where patients with DU experience less sensation of filling (Gammie).REC name
South West - Frenchay Research Ethics Committee
REC reference
18/SW/0248
Date of REC Opinion
31 Dec 2018
REC opinion
Further Information Favourable Opinion