Study day clinical cases 2012 2nd Seminar Clinical cases in urodynamics. One morning with Paul Abrams Presented by: Dr. Jose Emilio Batista Centro Médico.

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Presentation transcript:

Study day clinical cases nd Seminar Clinical cases in urodynamics. One morning with Paul Abrams Presented by: Dr. Jose Emilio Batista Centro Médico Teknon Barcelona, Spain

Study day clinical cases 2012 Detailed clinical hystory 65 years old male. 2 prostatitis, last one in january Daytime urinary frequency : 2-3hours Nocturia: 0-1(before january 2-3 times) Incomplete emptying feeling. Urgency without incontinence. No pharmacological treatment.

Study day clinical cases 2012 Urodynamic test: Uroflowmetry Tracing Qura Vol Voided volume. 237 ml Qmax. 14.9ml/s Postvoided residual. 114 ml

Study day clinical cases 2012 Urodynamics: Cystometry Tracing Pves Pabd Pdet

Study day clinical cases 2012 Urodynamics: Cystometry Infused Vol P vesP det First desire 210 ml50 cmH2O 5 cmH2O Cysto cap. 440 ml91 cmH2O 37 cmH2O

Study day clinical cases 2012 Urodynamics: Cystometry Comment : –Normal bladder capacity. –Diminished compliance. –No leakage with increased abdominal pressure. –Un-inhibited detrusor contractions. Filling phase dysfunction.

Study day clinical cases 2012 Urodynamic test: Pressure/Flow Study Tracing Pves Pabd Pdet Qmax Vol

Study day clinical cases 2012 P/Q Plot

Study day clinical cases 2012 Urodynamic test: Pressure/Flow Study Voiding phase results –Qmax16.1ml/s –Pdet at Qmax71cmH2O –Voided Volume467ml –Post Voided Residual0ml

Study day clinical cases 2012 Urodynamic test: Pressure/Flow Study Comment –Normal Qmax (16 ml/s). –Post voided volume: 0 ml. –Voiding by detrusor contraction. –Use of abdominal straining

Study day clinical cases 2012 Urodynamic test: Pressure/Flow Study Tracing Pves Pabd Pdet Qmax Vol

Study day clinical cases 2012 Therapeutic approach Filling phase: –Overactive detrusor. Voiding phase: –Limit values of obstruction, coexisting obstruction and no obstruction parameters. Anticholinergic and alpha-blocker treatment is inidicated. Urodynamic test is recommended to repeat in two months with the medication.