PMID- 22701539
OWN - NLM
STAT- MEDLINE
DCOM- 20121018
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 7
IP  - 5
DP  - 2012
TI  - External urethral sphincter pressure measurement: an accurate method for the 
      diagnosis of detrusor external sphincter dyssynergia?
PG  - e37996
LID - 10.1371/journal.pone.0037996 [doi]
LID - e37996
AB  - BACKGROUND: Combined pelvic floor electromyography (EMG) and 
      videocystourethrography (VCUG) during urodynamic investigation are the most 
      acceptable and widely agreed methods for diagnosing detrusor external sphincter 
      dyssynergia (DESD). Theoretically, external urethral sphincter pressure (EUSP) 
      measurement would provide enough information for the diagnosis of DESD and could 
      simplify the urodynamic investigation replacing combined pelvic floor EMG and 
      VCUG. Thus, we evaluated the diagnostic accuracy of EUSP measurement for DESD. 
      PATIENTS #ENTITYSTARTX00026; METHODS: A consecutive series of 72 patients (36 
      women, 36 men) with neurogenic lower urinary tract dysfunction able to void 
      spontaneously was prospectively evaluated at a single university spinal cord 
      injury center. Diagnosis of DESD using EUSP measurement (index test) versus 
      combined pelvic floor EMG and VCUG (reference standard) was assessed according to 
      the recommendations of the Standards for Reporting of Diagnostic Accuracy 
      Initiative. RESULTS: Using EUSP measurement (index test) and combined pelvic 
      floor EMG and VCUR (reference standard), DESD was diagnosed in 10 (14%) and in 41 
      (57%) patients, respectively. More than half of the patients presented discordant 
      diagnosis between the index test and the reference standard. Among 41 patients 
      with DESD diagnosed by combined pelvic floor EMG and VCUR, EUSP measurement 
      identified only 6 patients. EUSP measurement had a sensitivity of 15% (95% CI 
      5%-25%), specificity of 87% (95% CI 76%-98%), positive predictive value of 60% 
      (95% CI 30%-90%), and negative predictive value of 56% (95% CI 44%-68%) for the 
      diagnosis of DESD. CONCLUSIONS: For diagnosis of DESD, EUSP measurement is 
      inaccurate and cannot replace combined pelvic floor EMG and VCUR.
FAU - Suzuki Bellucci, Carlos H
AU  - Suzuki Bellucci CH
AD  - Neuro-Urology, Spinal Cord Injury Center & Research, Balgrist University 
      Hospital, University of Zurich, Zurich, Switzerland.
FAU - Wollner, Jens
AU  - Wollner J
FAU - Gregorini, Flavia
AU  - Gregorini F
FAU - Birnbock, Dorothee
AU  - Birnbock D
FAU - Kozomara, Marko
AU  - Kozomara M
FAU - Mehnert, Ulrich
AU  - Mehnert U
FAU - Kessler, Thomas M
AU  - Kessler TM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120531
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Electromyography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Urethra/*physiopathology
MH  - Urinary Bladder Diseases/*physiopathology
MH  - Urodynamics/physiology
MH  - Young Adult
PMC - PMC3365101
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2012/06/16 06:00
MHDA- 2012/10/19 06:00
PMCR- 2012/05/31
CRDT- 2012/06/16 06:00
PHST- 2012/01/13 00:00 [received]
PHST- 2012/05/01 00:00 [accepted]
PHST- 2012/06/16 06:00 [entrez]
PHST- 2012/06/16 06:00 [pubmed]
PHST- 2012/10/19 06:00 [medline]
PHST- 2012/05/31 00:00 [pmc-release]
AID - PONE-D-12-01644 [pii]
AID - 10.1371/journal.pone.0037996 [doi]
PST - ppublish
SO  - PLoS One. 2012;7(5):e37996. doi: 10.1371/journal.pone.0037996. Epub 2012 May 31.