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Manual of Urodynamics
Mayank Mohan Agarwal
CHAPTER 1:
Anatomy and Physiology of the Lower Urinary Tract
ANATOMY OF THE LOWER URINARY TRACT
FUNCTION OF THE LOWER URINARY TRACT
NEURAL CONTROL OF THE LOWER URINARY TRACT
Storage Phase
Reflexes in the Storage Phase
Voiding Phase
Reflexes in the Voiding Phase
SUGGESTED READING
CHAPTER 2:
Clinical Assessment of a Patient with Lower Urinary Tract Symptoms
HISTORY
Lower Urinary Tract Symptoms (LUTS)
Pain
Other Processes which may Affect LUT Function
Urinary Tract Infection
Defecation
Other Symptoms
EXAMINATION
Male-specific
Female-specific
Pelvic Examination
Pelvic Support Defect (Figure 1)
Bladder Diary
CHAPTER 3:
Uroflowmetry
TYPES OF UROFLOWMETERS
STANDARDIZATION REQUIREMENTS OF THE EQUIPMENT
Setup
HOW TO READ AND INTERPRET UROFLOW DATA
Measurements
Flow Patterns (Figures 7A to E)
Postvoid Residual Urine (PVRU)
Flow-volume Nomograms
Volume Corrected Q
SUGGESTED READING
CHAPTER 4:
Cystometry and Pressure-flow Study
HARDWARE
Base Unit
Catheters
Electrodes
Introduction
Setup/Equipment
Preparation of the Patient
Performing the Test
Zeroing
THE FILLING PHASE
Compliance
The Leak Point Pressures
Detrusor Overactivity
THE MICTURITION PHASE
Interpretation of the Results
Detrusor Contraction Pattern
SUGGESTED READING
CHAPTER 5:
Video Urodynamics
SETUP
PROCEDURE
INDICATIONS OF VIDEO URODYNAMICS
Postprostatectomy Dysfunction
Neurogenic Bladder
Detrusor Underactivity
Stress Urinary Incontinence in Women
To Differentiate Primary Bladder-Neck Obstruction from the Pelvic Floor Dysfunction
ADVANTAGES OF VUDS (OR VCUG DONE SEPARATELY WITHIN A SHORT INTERVAL)
SUGGESTED READING
CHAPTER 6:
Urethral Pressure Profilometry (UPP)
INTRODUCTION
STRESS UPP
Leak Point Pressure
Pressure Transmission Ratio
MICTURITIONAL UPP (MUPP)
CHAPTER 7:
Ambulatory UDS
TECHNIQUE
INTERPRETATION
CHAPTER 8:
Whitaker Test
INTRODUCTION
PROCEDURE
INTERPRETATION OF RESULTS
ROLE OF WHITAKER TEST
DRAWBACKS OF WHITAKER TEST
SUGGESTED READING
CHAPTER 9:
Representative Case Discussion
PATIENT 1
Examination
Uroflowmetry
Pressure-flow Analysis
UPP (Figure 2A)
Description of Resting Profile
Description of Micturitional Profile
Interpretation
PATIENT 2
Examination
Ultrasound
Uroflometry
PATIENT 3
Cystometry
PATIENT 4
Cystometry
CHAPTER 10:
Reporting Urodynamics
FILLING PHASE
Bladder
Urethra
EMG
Cystography
STRESS PHASE
Bladder
Urethra
EMG
Cystourethrography
MICTURITIONAL PHASE
Bladder
Urethra
Cystourethrography
EMG
INDEX
TOC
Index
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