Harm J. Rollema

Bio: Harm J. Rollema is an academic researcher from St Bartholomew's Hospital. The author has contributed to research in topics: International Prostate Symptom Score & Lower urinary tract symptoms. The author has an hindex of 4, co-authored 6 publications receiving 535 citations.

Standardization of terminology of lower urinary tract function: pressure-flow studies of voiding, urethral resistance, and urethral obstruction

Abstract: textThe 1988 version of the collated reports on standardisation of terminology, which appeared in Neurourology and Urodynamics, vol. 7, pp. 403–427, contains material relevant to pressure flow studies in many different sections. This report is a revision and expansion of Sections 4.2 and 4.3 and parts of Sections 6.2 and 7 of the 1988 report. It contains a recommendation for a provisional standard method for defining obstruction on the basis of pressure-flow data. 2. Evaluation of Micturition 2.1. Pressure-Flow Studies At present, the best method of analysing voiding function quantitatively is the pressure-flow study of micturition, with simultaneous recording of abdominal, intravesical and detrusor pressures and flow rate (Fig. A.1.6.1). Direct inspection of the raw pressure and flow data before, during and at the end of micturition is essential, because it allows artefacts and untrustworthy data to be recognised and eliminated. More detailed analyses of pressure-flow relationships, described below, are advisable to aid diagnosis and to quantify data for research studies. The flow pattern in a pressure-flow study should be representative of free flow studies in the same patient. It is important to eliminate artefacts and unrepresentative studies before applying more detailed analyses. Pressure-flow studies contain information about the behaviour of the urethra and the behaviour of the detrusor.

Repeated pressure-flow studies in the evaluation of bladder outlet obstruction due to benign prostatic enlargement

Abstract: Test-retest reliability of repeated voids in pressure-flow studies and the influence on maximum flow rate (QmaxpQ), detrusor pressure at maximum flow rate (pdetQmax), voided volume, and residual urine were studied. Also the agreement in interpretation of pressure-flow tracings between investigators and a single blinded central reader acting as a quality control center (QCC) were assessed. In addition, correlations between pdetQmax and patient age, International Prostate Symptom Score (IPSS), free maximum flow rate (Qmax), and prostate volume were calculated. Using suprapubic pressure recording, 216 men with lower urinary tract symptoms (LUTS) due to benign prostatic enlargement (BPE) were investigated in 11 centers. In each pressure-flow study, three sequential voids were performed, and quality controlled recordings were analyzed for QmaxpQ and pdetQmax by the QCC. Trans- rectal ultrasound was used to measure the prostate volume. Mean QmaxpQ did not change, but pdetQmax decreased significantly in the second and third sequential voids. Using the Abrams-Griffiths nomogram definition of obstruction, 125 patients (67%) were classified as obstructed from the first void, but only 111 patients (59%) from the third void. The agreement between the investigator assessment and that of a single blinded reader was good. There was no significant correlation between pdetQmax and patient age, IPSS, and Qmax, whereas a modest correlation was found between pdetQmax and prostate volume. In summary, there was no significant change in QmaxpQ, but pdetQmax decreased for the three consecutive voids, which can be explained by a decrease in outlet resistance. The agreement between the investigator and QCC interpretations shows the value of a standardized technique, supporting the feasibility of multicenter urodynamic studies. There is a modest, but statistically significant, correlation between detrusor pressure and prostate size, supporting the hypothesis that prostate size is a contributing factor in symptomatic BPH. Neurourol. Urodynam. 18:17–24, 1999. © 1999 Wiley-Liss, Inc.

Method and system for on-line measurement, storage, retrieval and analysis of urodynamical data

Abstract: A computerized urological diagnostic method and system for use, for example, in preoperative assessment of prostatectomy candidates and other therapeutical measures in patients (males and females) with voiding complaints. The system includes a digital processor, a database, suitable input/output devices, and pressure and flow rate trandsucers for measure the patient's isometric detrusor pressure immediately before voiding and detrusor pressure and flow rate during micturition. These signals are processed and displayed to provide the clinician with objective data of bladder contractility and urethral resistance. With such data, the clinician can make informed treatment decisions.

The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society.

Abstract: The standardisation of terminology of lower urinary tract function: Report from the standardistation sub-committee of the International Continence Society.

Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies

Abstract: This is the first report of the International Continence Society (ICS) on the development of comprehensive guidelines for Good Urodynamic Practice for the measurement, quality control, and documentation of urodynamic investigations in both clinical and research environments. This report focuses on the most common urodynamics examinations; uroflowmetry, pressure recording during filling cystometry, and combined pressure-flow studies. The basic aspects of good urodynamic practice are discussed and a strategy for urodynamic measurement, equipment set-up and configuration, signal testing, plausibility controls, pattern recognition, and artifact correction are proposed. The problems of data analysis are mentioned only when they are relevant in the judgment of data quality. In general, recommendations are made for one specific technique. This does not imply that this technique is the only one possible. Rather, it means that this technique is well-established, and gives good results when used with the suggested standards of good urodynamic practice.