Urodynamics study

Urodynamic study

Urodynamic study is an important part of the evaluation of patients with voiding dysfunctions—dysuria, urinary incontinence, neuropathic disorders, etc.

Urodynamics is the study of the transport, storage, and evacuation of urine by the urinary tract. It is comprised of a number of tests that individually or collectively can be used to gain information about lower urinary tract function and can provide a precise diagnosis of the etiology of voiding dysfunction.

Multichannel Urodynamics

The various components of the urodynamic evaluation include;
• Cystometrogram: monitoring of bladder pressure during filling,
• Voiding pressure flow study: monitoring of bladder pressure and simultaneous urinary flow rate during voiding.
• Electromyography: monitoring of pelvic floor and external sphincter activity.
• Usually abdominal pressure is also monitored during filling and voiding so that subtracted detrusor pressure can be determined.
• In select cases, the urethral pressure can also be assessed during storage and voiding (urethral pressure profilometry). It is when these components are combined together as “multichannel urodynamics” that a most sophisticated.
• Uroflowmetry: study of urinary flow rate




Nomenclature
The study of urinary flow rate itself is usually called uroflowmetry.
The flow rate is generally identified as maximum flow rate, average flow rate, flow time, maximum flow time (the time elapsed before maximum flow rate is reached), and total flow time (the aggregate of flow time if the flow has been interrupted by periods of no voiding).
The flow rate pattern is characterized as continuous or intermittent, etc.









Figure 1. Uroflowmetry Basic elements of maximumflow, average flow,total flow time, and total volume voided.
Indications for urodynamics
• Anatomical abnormalities congenital
Acquired
• Injuries ; brain, spinal cord, abdomen, pelvic, bladder or urethral injuries
• Infections; acute or chronic infection
• Tumors; pelvic organ, bladder or prostatic tumours
• Benign prostatic hyperplasia
• Chronic diseases; D.M., M.S., ….etc
• Psycholologic disorders.
• Neurologic injuries or diseases.