Non-invasive measurement of urinary bladder pressure using condom catheter test was developed since mid 90s. The test was later modified and repeatedly examined for applicability and reproducibility with success during the last 20 years. Its main drawback was its low correlation with invasive urodynamic pressures in some of the more obstructed patients. In those obstructed patients, it takes a relatively prolonged time for the pressure within the condom to reach a steady state. This delay raised concerns as it could theoretically result in Detrusor inhibition or sphincter closure leading to underestimation of isovolumetric bladder pressure. This prototype of modified condom catheter test aims to make it simpler and faster to reach the isovolumetric pressure in more obstructed patients.

To test a modified condom catheter test prototype for measurement of transmitted isovolumetric pressure and compare it with invasive isovolumetric pressure using the manual penile compression test (Pinch test) in obstructed male patients.
 29 male patients with obstructive symptoms due to prostatic enlargement were enrolled in this study. 
 We used a single outflow condom catheter attached to the penis with a y-shaped connector attached to it. One limb of the Y was attached to pressure transducer and the other limb was used to make the condom air free to avoid artifacts during pressure measurement then was blocked. The condom was stiffened with adhesive tape to lower its compliance and limit its distensibility to maximal capacity of 70-120 ml. The tape was extended to the penile skin to guard against leakage.  The patients were instructed not to strain during voiding and we excluded results associated with any straining. Maximal recorded pressure was designated as Transmitted Isovolumetric pressure. Pressure-flow test was done in another day with interruption of flow during voiding using manual compression of the penis (Pinch test). Isovolumetric pressure was recorded and compared with transmitted isovolumetric pressure of modified condom test. Statistical analysis was done using Bland-Altman method to test for agreement between both tests and Shapiro-Wilk test for difference between both tests.

: Mean patients age was 64.1 +/-7.5 years. Median IPSS sore was 22 (range 15-30). Mean bladder volume was 347+/-121 ml. Free flow showed mean Qmax of 8.4+/-2.7 ml/sec. Mean transmitted isovolumetric pressure was106.8 +/-31 cm/H2O. Mean invasive isovolumetric pressure was 103.7+/-30 cm/H2O. No significant difference in distribution between both pressures was found using Shapiro-Wilk test (p=0.22 6)

No significant difference was found between modified condom catheter test and invasive stop-flow test in obstructed adult male patients. This may be due to faster filling of the condom and its quicker pressurization in those patients with low flow.

Modified condom catheter showed a good correlation between isovolumetric bladder pressure measured both invasively and non-invasively in obstructed male patients. A further study in larger cohort of patients is still required