CONTINUOUS OCCLUSION TEST TO DETERMINE DETRUSOR CONTRACTILE PERFORMANCE

Purpose: A study was conducted to determine the merits of the continuo us occlusion test as a method of detrusor contractility assessment by comparing it with other stop tests and with contractility derived from pressure-flow analysis.Materials and Methods: The continuous occlusio n test was performed in elderly men by occluding the bladder outlet be fore the onset of a detrusor contraction and it was repeated to assess reproducibility. The magnitude of the isovolumetric contraction, maxi mum slope of the detrusor contraction, and duration of detrusor activa tion were determined. Voluntary and mechanical stop tests were perform ed during the mid voiding phase. Continuous occlusion test parameters were compared with the pressure-flow contractility parameters. Results : The continuous occlusion test was evaluated in 159 patients. The max imum isovolumetric contraction pressure of the continuous occlusion te st was significantly higher than that of the voluntary stop test (49 p atients). Continuous occlusion test contractility parameters were repr oducible. The maximum isovolumetric contraction pressure and the maxim um slope of the detrusor contraction of the continuous occlusion test significantly correlated with the estimated maximum isovolumetric cont raction pressure and estimated velocity of shortening (derived from pr essure-flow), respectively (r = 0.79, p <0.0001 and r = 0.385, p = 0.0 16, 39 patients). The watts factor was well correlated with maximum is ovolumetric contraction pressure (r = 0.75, 39 patients). Conclusions: Our study suggests that the continuous occlusion test can be used as an effective alternative method of assessing detrusor contractility.