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A URODYNAMIC STUDY

Urodynamic studies are essential for diagnosing bladder dysfunction and urinary tract symptoms. They involve various tests, including free flow, transperineal scans, and cystometry, to assess bladder pressures during filling and emptying. The aim is to reproduce symptoms in a controlled environment, ensuring reliable measurements. Patients complete homework tasks such as bladder diaries and pad tests to provide essential data. Each test evaluates distinct parameters like voiding time, flow rate, and the strength of pelvic floor muscles, aiding in accurate diagnoses and effective treatment plans.

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A URODYNAMIC STUDY

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  1. A URODYNAMIC STUDY The Whole Works Wendy McArthur

  2. Components Of Test • Homework • Free Flow • Transperineal Scan • Peritron Test • Cystometry • Leak Point Pressure • Pressure Flow

  3. Urodynamics • Examination of the lower urinary tract • Test the bladder pressures during filling and emptying • Helps determine the cause of bladder symptoms

  4. Aim Of Urodynamics • To reproduce the symptoms under controlled and measured conditions • Need technically reliable measurements • Experience so technique is second nature • put patient at ease • reproduce their usual behaviour

  5. Homework • Uro Kit includes • Questionnaire • Bladder Diary • Pad Test • MSU Form

  6. Questionnaire • Relating to bladder symptoms • Relevant medical history • Obstetric history • Medications

  7. Bladder Diary • Recordings over 24hours • Fluid intake • Fluid output • Guage output volumes • Frequency • Nocturia

  8. Pad Test • Pre weighed pad • Drink 1 litre of water • Wait 1 hour • Do set exercises with pad in pants • Remove pad • Measure urine • Weigh pad when returned

  9. Laboratory Tests • Mid stream Urine • Urine Cytology for pts over 60

  10. Free Flow • Full bladder • Privacy, normal as possible • Measures • voiding time • flow rate • time to maximum flow • volume passed

  11. Transperineal Scan • Measure descent of bladder neck • Push into bottom

  12. Peritron • Measures strength of pelvic floor muscles • Probe in vagina • Connect to abdominal pressure line • Squeeze and hold - try for 40 seconds • Normal strength = 30-40 cm H2O

  13. Cystometogram • Recording of bladder pressure as filled • Sensory catheter in bladder = Pves • Balloon catheter in rectum = Pabd • Computer calculation of detrussor pressure Pdet = Pves - Pabd

  14. Assessment of Cystometogram • Note first sensation in bladder • First urge - about 50% capacity • Normal desire - able to hold on • Strong desire - persistant with no leakage • Does the bladder relax and accommodate the fluid • Does the detrussor pressure stay even

  15. Leak Point Pressure • Valsalva movement sitting • Full bladder • Cough standing • Measure leak point pressure

  16. Pressure Flow • Pressure lines recording • Detrussor pressure • Abdomonal pressure

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