Urology Today.net

Site updated at Thursday, 17 July 2014

Common Urological Problems

Frequency

Office Evaluation of Urinary Incontinence

Introduction
The goals of the basic evaluation are to confirm urinary incontinence (UI)  and to identify factors that may be contributing to or resulting from UI. The general evaluation of UI should include a history, fluid intake/voiding diary, physical examination, urinalysis, urine culture, and measurement of postvoid residual urine. For selected patients, a… Office Evaluation of Urinary Incontinence   



Multichannel Urodynamics

The workup described constitutes the basic office assessment (BOA) of UI; it is generally accepted. However, the role of urodynamics in the evaluation of patients with UI is controversial. This is because the true impact of urodynamics on clinical diagnosis, management plans, and patient’s outcome has not been studied in a well-designed manner. As… Multichannel Urodynamics   



Findings in NonNeurogenic Overactive Bladder

Although no clear criteria exist for differentiating neurogenic from idiopathic DO, it has been suggested that unstable bladder contractions occurring as a result of neurological disease may be more likely to result in urge incontinence (17) and have a greater amplitude. Regardless, perhaps the most common urodynamic pattern seen in patients with idiopathic OAB… Findings in NonNeurogenic Overactive Bladder   



Findings in Neurogenic OAB

Patients with neurogenic OAB tend to have severe symptoms that are more difficult to treat pharmacologically. It is not immediately clear that the overactive contractions experienced by patients with neurological conditions are necessarily of greater amplitude or occur earlier during filling, although there is some indirect evidence to support this contention (13). Phasic detrusor… Findings in Neurogenic OAB   



Urodynamic Evaluation of Female Stress Urinary Incontinence

Introduction
The American Urological Association has published guidelines for the surgical management of female stress urinary incontinence (1). According to these guidelines, the objective demonstration of stress urinary incontinence should be documented prior to initiating surgical therapy.  This can be accomplished with physical examination (filling the bladder and observing stress incontinence with cough… Urodynamic Evaluation of Female  Stress Urinary Incontinence   



Urethral pressure profilometry

Historically, the first urodynamic parameter measured to characterize stress incontinence was the resting urethral pressure profile (UPP), which was based on the idea that continence is maintained as long as urethral pressure exceeds intravesical pressure. It was thought that measuring the pressure exerted by the urethra in relation to the intravesical pressure would predict… Urethral pressure profilometry   



Urethral Retroresistance Pressure

A new urodynamic measurement system for urethral retroresistance pressure (URP) has been described. URP is defined as the pressure required to achieve and maintain an open urethral sphincter and is measured by occluding the urethral meatus with a cone-tipped plug placed 5 mm in the urethra.

Sterile fluid is then infused retrograde at… Urethral Retroresistance Pressure   



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