Diagnosis and grading of detrusor instability using a computerized algorithm

The Journal of Urology
J GroenR van Mastrigt

Abstract

Detrusor instability and hyperreflexia are characterized by involuntary detrusor contractions in the filling phase of the voiding cycle. The diagnosis is made when urodynamic evaluation reveals such contractions. To compare patients and evaluate treatment a method is needed to quantify the degree of instability. We developed an instability parameter based on the area under the curve of involuntary detrusor contractions on conventional filling cystometry. We developed an automatic method to calculate the area under the curve of involuntary detrusor contractions in conventional filling cystometry. Logistic regression was used to construct decision rules to differentiate stable from unstable bladders. These rules, derived from a group of 100 children, were applied to a second group of 77 who were independently assessed by 3 urodynamics experts. Typically 88% of the second group were correctly classified as stable or unstable by the automatic procedure. In the unstable subgroup there was poor correlation between the calculated instability parameter and the instability score assigned by the experts. Most likely this difference occurred because the experts based their opinion mainly on the amplitude of the highest unstable contractio...Continue Reading

Citations

Aug 22, 2009·The Journal of Urology·An BaelUNKNOWN European Bladder Dysfunction Study EU BMH1-CT94-1006
Aug 25, 1999·Current Opinion in Urology·J Sullivan, P Abrams
Jan 17, 2002·The Journal of Urology·K L MillerN M Resnick

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