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A URODYNAMIC STUDY The Whole Works Wendy McArthur
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2 Components Of Test Homework Free Flow Transperineal Scan Peritron Test Cystometry Leak Point Pressure Pressure Flow
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3 Urodynamics Examination of the lower urinary tract Test the bladder pressures during filling and emptying Helps determine the cause of bladder symptoms
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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
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5 Homework Uro Kit includes Questionnaire Bladder Diary Pad Test MSU Form
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6 Questionnaire Relating to bladder symptoms Relevant medical history Obstetric history Medications
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7 Bladder Diary Recordings over 24hours Fluid intake Fluid output Guage output volumes Frequency Nocturia
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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
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9 Laboratory Tests Mid stream Urine Urine Cytology for pts over 60
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10 Free Flow Full bladder Privacy, normal as possible Measures –voiding time –flow rate –time to maximum flow –volume passed
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13 Transperineal Scan Measure descent of bladder neck Push into bottom
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14 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
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16 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
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17 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
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18 Leak Point Pressure Valsalva movement sitting Full bladder Cough standing Measure leak point pressure
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19 Pressure Flow Pressure lines recording Detrussor pressure Abdomonal pressure
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