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…    



Fluid Intake/Voiding Diary

Patient histories regarding frequency and severity of urinary symptoms are often inaccurate. A more reliable indicator of symptoms is a fluid intake/voiding diary, which should be distributed to patients.

They would be instructed to document in it the amount and type of fluid consumed and the volume and time of voiding and leakage…    



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…    



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 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…    



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…    



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 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…    



Role of Urodynamic Testing in the Assessment of Female SUI

Although urodynamic testing is frequently performed as part of the evaluation of SUI, the benefits obtained by performing such testing have not been well defined. Advocates of a “minimalist” approach argue that direct observation of stress incontinence on physical examination is sufficient to allow the treating physician to proceed with surgery in the majority…    



The concept of ‘overactive bladder’ serves better commercial rather than patient interests

“The overactive bladder syndrome has become an accepted way to simplify a complex array of symptoms and leads people to believe that an overactive bladder is an independent disease in itself. However, the truth is not as simple as this, as there are usually several factors at work explaining the symptoms. This is also…