Non-Invasive Bladder Analysis For Men

Medical Professionals

Fast, accurate testing you can rely on

The CT3000 uses a method similar to that of obtaining blood pressure. A penile cuff is fitted to the patient who is then asked to void in the normal way. An estimate of isovolumetric bladder pressure, pcuff.int, and a measurement of maximum flowrate, Qmax.cuff, are obtained and plotted on a nomogram to allow categorisation into obstructed, not obstructed, or diagnosis uncertain groups. Men whose measurements fall in the obstructed area have an 87% chance of a good outcome from TURP and those classified as not obstructed have a much reduced chance of benefit and might prefer to put up with their symptoms. For the 45% of men whose obstructive category remained uncertain, the chance of a good outcome was intermediate and similar to that predicted by standard assessment. The choice for these men would be to accept the moderate risk of unsatisfactory symptom relief or undergo further testing, perhaps by invasive PFS, to clarify their urodynamic status.

How does the CT3000 compare to invasive PFS?

Studies have shown that an 87% success rate in men classified as obstructed was similar to that achieved by invasive PFS in previous studies (79–93%).

The financial benefits

In England, where 15,000 men undergo TURP for LUTS each year, good outcome could be predicted with greater certainty for 6000 men, whereas, for the 3000 men classified as not obstructed, the risk–benefit ratio would merit more careful consideration and a proportion might opt for continued surveillance. This represents a significant cost and time saving for the NHS. For a typical hospital the savings could be tens of thousands of pounds per year.

Helping you diagnose correctly

So you can monitor the progress of the test, real-time results are displayed throughout the session on the CT3000’s touch screen monitor. After the test is complete the results are printed out in a clear and concise manner that aids patient diagnosis.

High performance analysis

Measures bladder contractility non-invasively
Reduces the number of cystometry tests and associated risks
Clinically proven
Reduces any waiting lists
Saves time and money
Increases the success rate from TURP
Also functions as a conventional flow meter

How to interpret the results

Step 1 – Was there good linear inflation? If yes, then it is OK to interpret the inflation cycle. If no, then you would have to ignore that particular inflation. This example is fine.

Step 2 – Was there resumption of flow? i.e. When the cuff deflated, did the flow go back to the pre-inflation level? In this example, all of the inflation cycles did apart from the last one, which is not highlighted. This would have printed on the second page.

Step 3 – What is the Qmax? Look at the graph and find Qmax ignoring the artefacts of when the cuff deflates and you get the characteristic surge. In this example it would be 7ml/s.

Step 4 – Check they have voided more than 150 mls. If yes, then it is a good test. If not, then you would have to repeat the test following the ICS guidlines.

Step 5 – Plot the individual valid graphs and use the one with the highest recorded interruption pressure. The arrows have been drawn on to show you what the interruption pressure is for this patient. We would use the first graph, which gives us 145 cm H20.

Step 6 – We plot the results on the Nomogram. So, Qmax of 7ml/s and an interruption pressure of 145 cm H20 makes the patient Obstructed. If you have a look at page 17 – 26 of the training manual, it will highlight what you can and cannot include in terms of a diagnosis.

Essentially:

Any surge should not be used to obtain Qmax
Any erratic flows should be looked at with caution
Any total voided volume lower than 150ml should be excluded
Straining is quite obvious and can be picked up and ignored so the cuff inflation still could be used.

Area’s of Diagnostic Uncertainty:

Top Right Quadrant – Check U & E’s, Symptoms? irritive, Empirical Treatment (drugs) or Invasive Urodynamic’s. Need to protect Upper Urinary Tract.

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