2nd Seminar Clinical cases in urodynamics. One morning with Paul Abrams

1. 2nd Seminar Clinical cases in urodynamics. One morning with Paul Abrams Presented by: Dr. Jose Emilio Batista Uordynamics Coordinator Centro Médico Teknon Barcelona

2. 22 year old woman. Increased daytime voiding frequency: 1h Nocturia: no. Sensation of incomplete emptying. No urinary tract infections. No gynecological and obstetric history. Osteopenia in treatment. Detailed clinical hystory

3. Tracing Urodynamic test: Uroflowmetry Voided volume. 288 ml Qmax. 25.1 ml/s Post voided residual. 36 ml Vol Qura

4. Tracing Urodynamic test:Cystometry Pabd Pves Pdet

5. Infused Vol P ves P det First desire 146 ml 25 cmH2O 2 cmH2O Cysto Cap. 235 ml 52 cmH2O 66 cmH2O Urodynamic test:Cystometry

6. Comment: Low bladder capacity. Diminished compliance. No leakage. No involuntary detrusor contractions detected. Filling phase dysfunction. Urodynamic test:Cystometry

7. Tracing Urodynamic test:Pressure/Flow Study Pabd Pves Pdet Vol Qura

8. Voiding phase results Qmax 14.1 ml/s Pdet at Qmax 54 cmH2O Voided volume 235 ml Post voided volume 0 ml Urodynamic test:Pressure/Flow Study

9. Comment Qmax in the limit (14.1 ml/s). Post voided residual: 0 ml. Micturition by detrusor contraction. Urodynamic test:Pressure/Flow Study

10. Tracing Urodynamic test:Cystometry Pabd Pves Pdet

11. Infused Vol P ves P det First desire 104 ml 8 cmH2O 5 cmH2O Cysto Cap. 304 ml 5 cmH2O 4 cmH2O Urodynamic test:Cystometry

12. Tracing Urodynamic test:Pressure/Flow Study Pabd Pves Pdet Vol Qura

13. Voiding phase results Qmax 14.6 ml/s Pdet at Qmax -9 cmH2O Voided volume 304 ml Post voided residual 0 ml Urodynamic test:Pressure/Flow Study

14. Filling phase: Bladder with low capacity and normal compliance. Voiding phase: No obstruction. Detrusor contractile. Anticholinergic treatment for symptoms. Rule out organic causes (TBC; cis) with a cystoscopy. Diagnostic approach