Why are continent catheterizable channels continent? A proof of principle urodynamic study.

Abstract

A continent catheterizable channel is an elegant option for patients who are unable to perform clean intermittent catheterization through the urethra. However, leakage through the channel is a frequently occurring complication. In stress incontinent woman, a urethra pressure profile can give insight about the incontinence mechanism. In this proof of principle study, we want to explore the feasibilities of pressure profilometry in the CCC in order to understand its continence mechanism better. We included all patients with a CCC or heterotopic continent pouch that underwent a urodynamic study in the University Medical Centre Utrecht between January and March 2023. We conducted a stoma pressure profile (SPP) at the beginning, thereafter we placed the catheter on the point of the highest pressure measured during the SPP. Here we conducted the continuous stoma pressure (CSP), at the end of the study we conducted a second SPP. The primary outcome is the technical feasibility of the pressure profilometries. The secondary outcome is the description of these profilometries. We included 14 patients, in whom we conducted 14 SPPs and 13 CSPs. The average maximal stomal pressure in SPP-2 was higher than in SPP-1, but no significant difference was found (P=.429). The average maximal stomal pressure in SPP-1, SPP-2 and CSP was higher in patients without stress incontinence compared to stress incontinent patients, however no significant difference was found. It is feasible to perform a stoma profilometry in adult patients. The mean pressures in SPP-2 were higher than in SPP-1, and the mean pressures in stress incontinent patients were lower. The results could help us in understanding the continence mechanism of the CCC and treatment of complications.