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Comparison of Urodynamic Volume Measurements Using Room and Body Temperature Saline: A Double-Blinded Randomized Crossover Study Design

Gehrich, Alan Paul MD*; Hill, Micah J. DO*; McWilliams, Grant D.E. DO; Larsen, Wilma MD; McCartin, Tamarin DO§

Female Pelvic Medicine & Reconstructive Surgery:
doi: 10.1097/SPV.0b013e3182532160
Original Articles
Abstract

Introduction: Urodynamic studies, routinely performed in women with lower urinary tract symptoms, have a large impact on clinical decision making. Unfortunately, these studies are insensitive in reproducing idiopathic detrusor overactivity (IDO). We set out to examine whether serial cystometry with different distending fluid temperatures could better reproduce symptoms.

Methods: Eighty-six women were enrolled in a double-blinded, randomized, crossover study. Two cystometries were performed in series, starting with either body temperature fluid (BTF) or room temperature fluid (RTF) and then repeating cystometry with the other temperature fluid. Primary outcomes included first sensation, first urge, and maximum cystometric capacity. Secondary outcomes included subjective sensation of bladder discomfort and the incidence of IDO.

Results: In aggregate, the temperature of the fluid did not affect volumes of bladder sensation. There were no differences in self-reported bladder irritation or IDO between the different temperature fluids. There was a significant carryover effect with BTF. BTF administered first reached sensory thresholds at lower volumes than when it was administered second after RTF. Room temperature fluid cystometry showed no statistical difference in volume between first fill and second fill. Idiopathic detrusor overactivity contractions were seen in 9% of studies and were not affected by period or temperature.

Conclusions: These data suggest that BTF and RTF independently do not affect bladder sensory thresholds. The periodicity in combination with varying fluid temperature is of greater impact. This study documents that changes in temperature of the distending fluid from BTF to RTF or vice versa likely do not provoke IDO contractions.

In Brief

Serial cystometry with body and room temperature fluid does not change bladder sensory thresholds or evoke increased motor responses in women with lower urinary tract symptoms.

Author Information

From the *Tripler Army Medical Center, Honolulu, HI; †Basset Army Community Hospital, Fairbanks, AK; ‡Scott and White Hospital, Temple, TX; and §Maui Community Hospital, Kahalui, HI.

Reprints: Alan Paul Gehrich, MD, Tripler Army Medical Center, Honolulu, HI, 96859-5000. E-mail: alan.gehrich@us.army.mil.

The authors declare that they have nothing to disclose.

The views expressed in this manuscript are those of the authors and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

© 2012 by Wolters Kluwer Health | Lippincott Williams & Wilkins