Can we improve our diagnosis of impaired detrusor contractility in women? An ICI-RS 2019 proposal

Phillip P. Smith*, Francoise Valentini, Konstantinos-Vaios Mytilekas, Apostolos Apostolidis, Kevin Rademakers, Linda Cardozo, Andrew Gammie

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Introduction Widely accepted consensus terminology and calculations of detrusor contractility in females do not exist but may be useful. We report the output of a proposal session at the International Consultation on Incontinence Research Society meeting 2019, addressing the title topic. Methods Three formal presentations and a lively discussion addressed several questions including: which is the optimal cutoff value of female bladder voiding efficiency during uroflow to suspect obstruction or detrusor underactivity? Is there a definition of pure underactive and pure obstructed voiding in females? Is there a place to distinguish those relatively obstructed from those relatively underactive females especially in those cases of equivocal obstruction? Current measures of contractility were reviewed for their usefulness in women. Results No recommendation for a specific index or calculation can be made based on current knowledge. "Contractility" may be context-dependent regarding clinical care, clinical prognostication, and physiologic research. Conclusions This group proposes that context-sensitive definitions of "Contractility" deserve attention by international leadership. Cooperative clinical and physiologic expertise will be needed to achieve this goal. Following initial recommendations based on expert opinion, the development of final definitions and measures of contractility should be iterative, based upon validation studies to be considered as part of the definitional process.

Original languageEnglish
Pages (from-to)S43-S49
Number of pages7
JournalNeurourology and Urodynamics
Early online date19 Dec 2019
Publication statusPublished - Jul 2020


  • detrusor contractility
  • female bladder physiology
  • urodynamics

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