Urodynamic effect

Results of four placebo-controlled comparative trials have not been as favorable, finding no significant clinical or urodynamic effect for oral estrogen compared with placebo. 

Early urodynamic effect. Permixon was administered to 75 patients with lower urinary tract symptoms resulting from mild-to-moderate BPH (mean IPSS 8.2), aged 52-78 years, at a dose of 160 mg twice daily for 9 weeks. Maximum urinary flow rate increased 6% (p < 0.001), and there was a reduction in detrusor pressure at maximum flow (12.8%, p < 0.001), opening detrusor pressure (12.6%, p < 0.001), and residual urine volume (12.6%, p < 0.05). The IPSS... 

Kuzmin, and R. R. Amdiy. Early urodynamic effects of the lipido-ste-rolic extract of Serenoa repens (Permixon ) in patients with lower urinary tract symptoms due to benign prostatic hyperplasia. Prostate Cancer Prostatic Dis 2000 3(3) 195-199. 

Geirsson, G., Fall, M., Sullivan, L. Clinical and urodynamic effects of intravesical capsaicin treatment in patients with chronic traumatic spinal detrusor hyperreflexia, J. Urol. 1995, 154, 1825-1829. 

Current evidence suggests that the urodynamic effects of epidural morphine are not dose-related, and the incidence is similar to that reported after intramuscular injections. Urinary retention is more frequent after the use of epidural opioids in volunteers compared with patients... 

Widman B. An experimental study of urodynamic effects of epidural morphine and of naloxone reversal. Anesth Analg 1983 62(7) 641-7. 

Castleden CM, Duffin HM, Briggs RS, Ogden BM. Clinical and urodynamic effects of ephedrine in elderly incontinent patients. J Urol 1982 128(6) 1250-1252. 

Several studies have evaluated whether the clinical and urodynamic effects of a combination of estrogen and an a-adrenergic receptor agonist exceed those of the individual therapies in SUI. In general, combination therapy has resulted in somewhat superior clinical and urodynamic responses compared with monotherapy, including severity of complaints, amount of urine lost per episode, number of daily voluntary micturitions, number of leakage episodes per day, patient preference, pad use, maximum urethral closure pressure, functional urethral length, and pressure transmission ratio. 

In open trials, estrogens were administered orally, intramuscularly, vagi-nally, or transdermally. Regardless of the route, estrogens exerted variable effects on urodynamic parameters, such as maximum urethral closure pressure, functional urethral length, and pressure transmission ratio. 

In a systematic review and pooled analysis of 32 controlled trials of anticholinergic therapy for overactive bladder (January 2002 database), the above agents were found to be modestly effective clinically and urodynamically. While the clinical relevance of the small improvements in clinical and urodynamic parameters were questioned, the effects of these agents were still considered positive. ... 

Patients with urinary frequency and urinary retention do benefit from urodynamical evaluation to determine the voiding pressures, the volume that triggers the void, the effect of abdominal pressure, and the volume of void. A urology nurse or a physician can prescribe appropriate medications to address the above issues. Urodynamics may be performed at the bedside by a trained nurse and can provide prompt information to assist with a plan to address incontinence. This examination will prevent unnecessary wetness and improve the continence outcomes. 

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