Urology Today.net

Site updated at Thursday, 12 May 2016

Common Urological Problems

Urge Incontinence

Urodynamic Assessment of Overactive Bladder - Neurogenic and Nonneurogenic

Introduction
Urodynamic studies (UDS)  generate information about bladder function that, currently, no other testing can provide. Though clearly not necessary to evaluate all lower urinary tract symptoms (LUTS), UDS can be useful when confronted with situations in which the normal noninvasive parameters used to assess LUTS, such as questionnaires, flow rates, and postvoid… Urodynamic Assessment of Overactive Bladder - Neurogenic and Nonneurogenic   



Key Components in Urodynamic Testing of Overactive Bladder

After the decision is made to proceed with urodynamic testing, the next consideration is the type of testing to be conducted. Most current urodynamic machines offer only multiple-channel testing because single-channel testing is prone to considerable artifacts.

In general, because it is difficult to predict for the presence of specific voiding dysfunction in… Key Components in Urodynamic Testing of Overactive Bladder   



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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