Urodynamics Made Easy

Front Cover\nInside Front Cover\nUrodynamics Made Easy\nCopyright\nContents\nForeword\nPreface\nAcknowledgements\nChapter 1: Clinical evaluation of the lower urinary tract\n	Introduction\n	Focused history and physical examination\n	Urodynamic evaluation\n		Indication and interpretation of urodynamics\n	Lower urinary tract symptoms terminology\nChapter 2: Basic structure, function and control of the lower urinary tract\n	Introduction\n	The kidneys and ureters\n	The urinary bladder\n	The urethra and sphincteric mechanisms\n		Male sphincteric mechanisms\n			Prostate gland\n		Female sphincteric mechanisms\n			Pelvic floor muscles\n	Function of the lower urinary tract\n		Storage phase\n		Voiding phase\n			Return to storage phase\n	Neuronal control of the lower urinary tract\n		Motor (efferent) control\n		Sensory (afferent) control\n		Involuntary storage reflexes\n		Desire to void\n		Voluntary control of voiding\n		Neuronal interactions\n	Conclusions\nChapter 3: Urodynamic procedures\n	Introduction\n	Indications for urodynamic assessments\n	Standardization and quality control\n	Aims of urodynamic investigations\n	Voiding diaries\n		Indications and aims\n		Method and standardization\n		Frequent findings\n		Bladder retraining\n	Pad testing\n		Indications and aims\n		Method and standardization\n		Practical points\n		Urodynamic parameters measured by pad testing\n		Normal values\n	Uroflowmetry\n		Indications and aims\n		Method and standardization\n		Normal values\n		Interpretation\n		Characteristic flow patterns\n			Normal\n			Fast bladder\n			Prolonged flow\n			Intermittent flow\n			Flat plateau\n		Practical points\n			Artefacts\n	Postvoid residual determination\n	Ultrasound cystodynamogram\n		Indications and aims\n		Method and standardization\n	Intravenous Urodynamogram\n		Indications and aims\n		Method and standardization\n	Urethral pressure measurement\n		Methods\n			Point pressure measurement\n			Urethral pressure profilometry\n			Fluid bridge test\n		Practical points\n		Urodynamic parameters measured by urethral pressure profilometry\n	Neurophysiological investigation\n		Methods\n	Upper urinary tract urodynamics\n		The Whitaker test\n		Practical points\nChapter 4: Pressure/flow cystometry\n	Introduction\n	Aims of pressure/flow cystometry\n		Pressure/flow cystometry techniques\n			Simple cystometry\n			Subtraction cystometry\n			Videocystometrography (also known as videocystometry and video urodynamics)\n			Ambulatory urodynamics (AUM)\n		Risks of pressure/flow studies\n		Subtraction cystometry or video urodynamics?\n		Terminology of pressure/flow cystometry\n	Equipment setup\n		Measuring the pressures\n			Catheter placement\n				Intravesical\n				Intraabdominal\n			Transducers\n				External fluid-charged pressure transducers\n				Catheter-mounted transducers\n				Air-charged pressure sensing technology\n		Filling the bladder\n			Catheter types\n				Dual lumen\n				Single lumen\n			Filling fluid\n			Fluid temperature\n		Quality control\n			Setting the zero pressure\n			Setting the reference height\n				External fluid-filled system\n				Microtip and air-filled systems\n			Resting pressures\n			Dampening and subtraction\n			Medications\n	Performing pressure/flow cystometry or video cystometry\n		Computer display\n		Cystometry stages\n		Storage phase\n			Fill rate\n			Patient position\n			Initial residual\n			Communication\n			Bladder sensations\n		Detrusor function during the storage phase\n			Normal detrusor function\n			Detrusor overactivity\n		Bladder compliance\n		Bladder capacity\n			Cystometric capacity\n			Maximum cystometric capacity\n		Urethral function during the storage phase\n		Leak point pressures\n			Abdominal leak point pressure (ALPP)\n			Detrusor leak point pressure (DLPP)\n			Video urodynamic screening during the storage phase\n		Voiding phase\n			Normal values\n		Detrusor function during the voiding phase\n			Normal detrusor function\n			Detrusor underactivity\n			Underactive bladder\n			Acontractile detrusor\n			After-contraction\n		Urethral function during the voiding phase\n			Normal urethral function\n			Bladder outflow obstruction (BOO)\n			Dysfunctional voiding\n			Detrusor sphincter dyssynergia\n			Nonrelaxing urethral sphincter obstruction\n			Video urodynamic screening during the voiding phase\n			Postvoid residual urine\n		Completion of a pressure/flow study\n		How to interpret the trace\n			Activity external to the bladder\n			Activity emanating from the bladder\n			Rectal activity\n		Troubleshooting\n			Ensuring that the resting values are feasible\n			Poor subtraction and dampening\n			Negative rectal pressure\n			Loss of trace activity\n			Sudden changes of pressure\n	Ambulatory urodynamics\n		Introduction\n		Indications\n		Equipment\n		Performing an AUM study\n		Analysis of results\nChapter 5: Storage disorders and incontinence\n	Introduction\n	Overactive bladder syndrome and urgency incontinence\n		Management of overactive bladder and urgency incontinence\n		Urodynamics in overactive bladder and urgency incontinence\n			Voiding diaries\n			1-hour pad test\n			Uroflowmetry\n			Pressure/flow cystometry\n			Nonurodynamic tests\n		Urodynamic findings in overactive bladder and urgency incontinence (Table 5.1)\n			Detrusor overactivity\n			Cough-induced incontinence\n	Stress incontinence\n		Management of stress incontinence\n		Urodynamics in stress incontinence\n			Voiding diaries\n			1-hour pad test\n			Uroflowmetry\n			Pressure/flow cystometry\n			Other urodynamic tests\n			Nonurodynamic tests\n		Urodynamic findings in stress incontinence\n			Video urodynamics\n				Bladder neck descent and hypermobility\n	Other types of incontinence\n		Mixed urinary incontinence\n		Overflow incontinence\n		Nocturnal enuresis\n		Unconscious incontinence\n		Situational urinary incontinence\n		Continuous urinary incontinence\n		Coexistence of different types of incontinence\n	Incontinence in men\n	Post-prostatectomy incontinence\n		Patient evaluation in post-prostatectomy incontinence\n		Management\nChapter 6: Voiding disorders and bladder outflow obstruction\n	Introduction\n	Anatomical bladder outflow obstruction\n		Benign prostatic obstruction\n		Malignant prostatic obstruction\n		Bladder neck obstruction\n		Urethral stricture\n		Evaluation of suspected bladder outflow obstruction\n		Indications for urodynamics to assess bladder outflow obstruction\n			Voiding diaries\n			Uroflowmetry and postvoid residual\n			Pressure/flow cystometry\n			Video urodynamics\n		Urodynamic findings in bladder outflow obstruction\n		Interpreting pressure/flow cystometry in bladder outflow obstruction\n	Functional obstruction (dyssynergia)\n		Dysfunctional voiding\n		Detrusor sphincter dyssynergia (DSD)\n		Nonrelaxing urethral sphincter obstruction\n		Fowlers syndrome\n		Evaluation of suspected functional obstruction\n		Urodynamic findings in functional obstruction\n	Detrusor underactivity and the underactive bladder\n		Chronic retention\n		Management of detrusor underactivity\n			Initial\n			Long term\n		Urodynamics in detrusor underactivity\n			Uroflowmetry and postvoid residual\n			Pressure/flow cystometry\n			Video urodynamics\nChapter 7: Sensory disorders\n	Introduction\n		Hypersensitivity\n			Increased bladder sensation\n		Evaluation of bladder hypersensitivity\n		Urodynamics in bladder hypersensitivity\n			Voiding diaries\n			Pressure/flow cystometry\n	Hyposensitive bladder\n		Reduced bladder sensation\n		Evaluation of bladder hyposensitivity\n		Management of bladder hyposensitivity\n		Urodynamics in bladder hyposensitivity\n			Voiding diaries\n			Uroflowmetry and postvoid residual\n			Pressure/flow cystometry\nChapter 8: The contracted bladder\n	Introduction\n	History and examination\n	Management\n		Urodynamics in bladder contracture\n			Pressure/flow cystometry\n		Urodynamics following cystoplasty\n			Management\nChapter 9: Neurogenic bladder disorders\n	Introduction\n	Patterns of neurogenic dysfunction\n		Suprapontine\n			Causes\n			Pattern of dysfunction\n		Pontine\n			Causes\n			Pattern of dysfunction\n		Suprasacral spinal cord\n			Causes\n			Pattern of dysfunction\n		Sacral and subsacral\n			Causes\n			Pattern of dysfunction\n	Urodynamics for neurogenic bladder disorders\n	Neurogenic detrusor and sphincter overactivity\n	Spinal shock\n	Practical points in performing pressure/flow cystometry\n		Detrusor leak point pressure\n		Autonomic dysreflexia\n	Electromyography\n		Types of electrode\n			Surface electrodes\n			Needle electrodes\n		Recording site\n		Interpretation\n	Other specialized neurophysiological studies\n		Nerve conduction studies\n		Evoked responses\n		Bethanechol supersensitivity test\n		Ice water test\nChapter 10: Paediatric urodynamics\n	Introduction\n	Paediatric lower urinary tract dysfunction\n	History and examination\n		Functional disorders\n	Indications for urodynamics\n	Urodynamic investigations\n		Uroflowmetry\n		Electromyography\n		Cystometry\n		Video urodynamics\n	Interpretation\n		Detrusor overactivity\n		Dysfunctional voiding\n		Detrusor sphincter dyssynergia\n		Compliance\nAppendix 1: Scheme for performing a pressure/flow study\n	Prior to the test: patient factors\n	Prior to the test: equipment factors and setup\n	Starting the test\n	Storage phase\n	Voiding phase\n	At the end of the study\nAppendix 2: Normal urodynamic values\n	Pad testing\n	Uroflowmetry\n	Pressure/flow studies\n		Storage\n		Voiding\n		Leak point pressures and urethral pressure profilometry\nAppendix 3: Example traces\nAppendix 4: Bibliography\n	Further reading\n	International continence society documents and reports\n	Clinical guidelines\nIndex\nInside Back Cover