Self-induced plantar-flexion objectively reduces wave amplitude of detrusor overactivity and subjectively improve urinary urgency: A pilot study

Authors

  • Kobi Stav,

    Corresponding author
    1. Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Beer Yaakov, Zerifin, Tel Aviv, Israel
    2. Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
    • Correspondence to: Kobi Stav, M.D., Neurourology Division, Department of Urology, Assaf-Harofeh Medical Center, Beer Yaakov, Zerifin 70300, Israel. E-mail: stavkobi@gmail.com

    Search for more papers by this author
  • Dan Leibovici,

    1. Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Beer Yaakov, Zerifin, Tel Aviv, Israel
    2. Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
    Search for more papers by this author
  • Siegel I. Yoram,

    1. Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Beer Yaakov, Zerifin, Tel Aviv, Israel
    2. Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
    Search for more papers by this author
  • Ohlgisser Ronny,

    1. Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Beer Yaakov, Zerifin, Tel Aviv, Israel
    2. Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
    Search for more papers by this author
  • Amnon Zisman

    1. Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Beer Yaakov, Zerifin, Tel Aviv, Israel
    2. Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
    Search for more papers by this author

  • Robert Pickard led the peer-review process as the Associate Editor responsible for the paper.
  • Conflict of interest: none.

ABSTRACT

Aims

To estimate the effect of plantar-flexion on the wave amplitude of involuntary detrusor contraction and the severity of urinary urgency during filling cystometry in patients with detrusor overactivity (DO).

Methods

Twenty-two consecutive patients with DO were enrolled. During urodynamics, the mean peak detrusor pressures of each contraction were documented and compared. At the beginning of the 2nd or 3rd wave, patients were asked to perform continuous plantar-flexion by pushing their tiptoes against the floor. Following each wave, patients were asked to grade the severity of the urgency by a visual analogue scale (VAS).

Results

The mean peak detrusor pressure without plantar-flexion was 58 cmH2O (95% CI: 46.3–69.7) compared to 31 cmH2O (95% CI: 23.1–38.9) with plantar-flexion (P < 0.001). All patients reported a reduced degree of urgency during plantar-flexion reflected in a significant reduction in mean VAS score from 9.3 (95% CI: 9–9.5) to 4.7 (95% CI: 3.9–5.4; P < 0.0001).

Conclusions

Self-performed plantar-flexion maneuver might reduce the severity of urinary urgency and the magnitude of overactive detrusor contractions, which may have a role in the conservative therapy of detrusor overactivity. Neurourol. Urodynam. 33:1247–1250, 2014. © 2013 Wiley Periodicals, Inc.

Ancillary