Evaluate the Effectiveness of Four Alternative Approaches for the Classical Cough Test During the Urodynamic Study in the Context of the COVID-19 Global Epidemic Situation

Objective To evaluate the four different alternatives to the classical cough test during a urodynamic study in the context of the COVID-19 pandemic. Materials and Methods Patients who needed to undergo a urodynamic study (UDS) at the West China Hospital of Sichuan University between April 2021 and May 2021 were randomly selected according to the inclusion and exclusion criteria. During the UDS process, we used four alternative methods to the “cough test”: 1) quickly pressing the bladder area, 2) performing the Valsalva maneuver, 3) performing the Kegel maneuver, and 4) letting the patient close their mouth while doing cough test. The "cough" waveform data were obtained and compared with the classical cough test. Results 120 patients (89 men, 31 women) were included in the study. There was no statistical difference between the cough waveform induced by the Valsalva maneuver compared with the classical cough test (P=0.150), no statistical difference between cough with closing mouth and classical cough test(P=0.255), no significant difference between pressing quickly on the bladder area and classical method(P=0.087), and there was a significant difference between the data obtained by the Kegel maneuver and the classical method (P<0.05). The average "cough" amplitude obtained was 73.14 ± 22.48 cm H2O, 66.17 ± 17.12 cm H2O, 82.93 ± 18.95 cm H2O, 26.50 ± 8.68 cm H2O, and 68.90 ± 20.32 cm H2O by the classical cough test, by quickly pressing the bladder area, by the Valsalva maneuver, by the Kegel maneuver, and by coughing with a closed mouth, respectively. Conclusion Quickly pressing the bladder area, performing the Valsalva maneuver, and letting the patient close their mouth while doing the cough test can all provide effective cough waveforms and amplitudes. Trial registration: No.2021–183.