Urodynamics/Uroflowmetry

DEPARTMENT OF UROLOGY EDUCATION

Production Team

Dr. Abraham Benjamin - Manager Medical InformaticsMr. Naresh Kumar - Coordinator Medical Informatics

What is Urodynamics?

Urodynamics is the name given to a series of tests designed to show how the Urinary Bladder functions.

Symptoms reported by the patient are often an unreliable

guide to the underlying dysfunction of the lower urinary tract.

The purpose of Urodynamics is to provide objective evidence for treatment. It can also be done to study the emptying of the urine from the kidney into the ureter.

Anatomy of urinary tract

Why are Urodynamics Performed ?

They are also performed in Men, Women and children who have

difficulty in passing Urine and also in patients of Urinary Leak,

Spinal Injury Patients and Patients who have defective Kidney by

Birth.

Most urodynamic tests focus on the bladder’s ability to hold urine

and empty steadily and completely.

Symptoms reported by the patient are often an unreliable guide to

the underlying dysfunction of the lower urinary tract. The purpose

of Urodynamics is to provide objective evidence for treatment.

What are the Symptoms for which Urodynamics are performed?

urine leakage.

frequent urination.

painful urination.

sudden, strong urges to urinate.

problems starting a urine stream.

problems emptying the bladder completely.

recurrent urinary tract infections.

What are the different type of Urodynamics Tests Performed?

Uroflowmetry.

Cystometry.

Pressure flow study.

Video urodynamic tests.

Urethral Pressure Profile (UPP)

Electromyography (EMG)

Whitakers test.

Uroflowmetry

The above picture shows a Uroflowmetry machine which measures the reading and gives the results immediately.

Uroflowmetry

Uroflowmetry is the measurement of urine speed and volume. Special equipment

automatically measures the amount of urine and the flow rate, and how fast the urine

comes out.

Uroflowmetry equipment includes a device for catching and measuring urine and a

computer to record the data. During a Uroflowmetry test, the person urinates privately

into a special toilet or funnel that has a container for collecting the urine and a scale.

The equipment creates a graph that shows when the flow rate is the highest and how

many seconds it takes to get there. Results of this test will be abnormal if the bladder

muscles are weak or urine flow is blocked.

Uroflowmetry Graphs

Normal Graph Obstructed Flow Graph

Cystometry

A cystometric test measures how much urine the bladder can hold, how

much pressure builds up inside the bladder as it stores urine, and how full

it is when the urge to urinate begins.

A catheter is used to empty the bladder completely. Then a special,

smaller catheter is placed in the bladder. This catheter has a pressure

measuring device called a manometer.

The patient is then asked to void, and both flow and pressure are

recorded. These are plotted against each other to create the

cystometrogram.

Cystometry Procedure and Graphs

above picture shows catheter placement Cystometrogram

Urethral Pressure Profilometry(UPP)

This urodynamic test measures pressure at the distal sphincter.

(The urinary control mechanism )

Pressure Flow Study A pressure flow study measures the simultaneous true

bladder pressure required to urinate and the flow rate.

This pressure flow study helps identify bladder outlet blockage that men may experience with prostate enlargement.

In this test the patient bladder is simulated for filling of the Urinary bladder and the patient urinary bladder is filled to the point of voiding and the pressure and flow rate are measured.

Video Urodynamic Tests:Video urodynamic tests take pictures and videos of

the bladder during filling and emptying. The imaging equipment may use real time xray imaging and these test are usually combined with the pressure flow tests.

When x rays are used the bladder is filled with a contrast Medium.

This test is usually combined with Pressure flow studies test.

Electromyography:

Electromyography uses special sensors to measure the electrical activity of the muscles and nerves in and around the bladder and the sphincters.

The sensors are placed on the skin near the urethra and rectum or on a urethral or rectal catheter. Muscle and nerve activity is recorded on a machine. The patterns of the nerve impulses show whether the messages sent to the bladder and sphincters are coordinated correctly.

Electromyography:

Whitakers Test: It is a urodynamic study, which has been used to evaluate

persistent upper urinary tract dilatation.

What Preparation is required by the patient for Urodynamics?

The patient will normally be asked to attend for the

tests with a comfortably full bladder.

Patient is required to take a laxative a night before

the test to ensure rectum is empty

Urine Culture should be negative before the

Urodynamics is performed

What to expect after Urodynamics test for a patient ?

After having urodynamic tests, the patient may feel mild discomfort for a few hours due to insertion of catheter while passing urine .

There might be a chance for Urinary Tract Infection

The Uroflowmetry test result is obtained immediately but the other tests need upto24 hr to interpret .

If you need to get this test done and meet our team of Urologists for Consultation click on the link below

http://www.ramayyapramila.com/

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