Abstract

YUAN TING, H.; TAVARES PINHEIRO, R.; DAMBROS, M.  and  PALMA, P.. Urodynamic studies about the use of the valsalva maneuver in the urination of men with inguinal hernias above the age of fifty. Actas Urol Esp [online]. 2007, vol.31, n.7, pp.771-775. ISSN 0210-4806.

Objective: To verify if the Valsalva Maneuver during urination in patients with inguinal hernias is associated with specific urodynamic findings. Method: Men, of over 50 years of age, who had inguinal hernias and visited a general surgery unit between May 2003 and November 2005, underwent an urodynamic study. They were mainly evaluated according to average urethral resistance (URA), the detrusal isometric contractibility (Pw) and urinal residue. The patients were divided into two groups: in the first group the Valsalva maneuver was not used during urination (Group I) while in the second group the Valsalva maneuver was employed (Group II). Initially, the data was expressed using the averages of the analysed parameters; they were then dichotomised according to the reference values. In order to carry out the statistical analysis, the qui quadrant and non conditional logistic regression were used. Results: One hundred patients took part in the research with an average age of 64.2 years of age (SD of ± 9.7 years). Group I was made up of 52 patients and Group II of 48 patients. The averages of the urodynamic parameters were compared between the two groups. It was found that the Group that carried out the Valsalva maneuver while urinating showed a damaged detrusal contractibility (p<0.01) and an increased urinal residue (p<0.02). When using logistic regression in order to express the odds ratios. The OR value was found to be 2.57 (IC 95%: 1.09-6.06) in the detrusal hypocontractibility group. Conclusion: The Valsalva Maneuver during urination is associated with the presence of detrusal hypocontractibility in patients affected by inguinal hernia.

Keywords : Inguinal hérnia; Valsalva Maneuver; Bladder outlet obstruction; Detrusal hypocontractibility.

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