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Urodynamic: visual library
IUGA Academy. Sandor C. Jun 30, 2018; 213275
Topic: Dysfunctional Voiding
Carola Sandor
Carola Sandor

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144

Urodynamic: Visual library

Sandor, C1; Fonseca, C1; Pavan, L1; Soderini, H1; Ubertazzi, E1

1: Hospital Italiano Buenos Aires

Introduction: Urodynamic study (UDS) includes a series of tests which are designed to evaluate the function of the lower urinary tract (LUT), providing functional information on bladder storage and voiding. The main objective of UDS is to reproduce the patient's symptoms and determine the origin of LUT disorders.

According to the International Continence Society (ICS), the standard urodynamic test should include uroflowmetry with evaluation of post void residual volume, transurethral cystometry and pressure-flow study1.

Currently UDS is frequently used in patients with stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) refractory to medical treatment, as well as in cases of mixed urinary incontinence, voiding disorders and patients with pelvic organ prolapse prior to surgical correction2.

The UDS represents a useful ancillary tool to evaluate the pathophysiology of LUT symptoms, as well as to improve the therapeutic approach.

Objective: The aim of the video is to display a visual library of the various normal and pathological urodynamic findings in patients complaining of LUT disorders.

Methods: We retrospectively reviewed the UDSs performed at the urogynecology section of a third level University Hospital from January 2015 to December 2017, where we documented the normal parameters as well as LUT disorders. The findings were classified according to the phase in which they are assessed: storage or voiding.

Results: One thousand UDS performed between January 2015 and December 2017 were evaluated, normal and altered parameters were registered.

We considered UDSs with different normal findings during storage phase and during the pressure/volume study, different mechanisms of micturition are also shown, such as contraction of the detrusor muscle, abdominal contraction and relaxation of pelvic floor muscles.

We documented changes in cystometry such as phasic or terminal involuntary detrusor contractions that may or may not be associated with UUI. We show the urodynamic findings compatible with SUI and mixed urinary incontinence. Cystometric alterations such as loss of compliance and urethral instability are also shown.

Regarding the voiding phase, alterations such as bladder outlet obstruction and detrusor-sphincter dyssynergia are shown in the pressure-flow studies.

Conclusions: The visual library shows the main urodynamic findings of patients with LUT disorders, which we believe are useful for personnel in training or at centers where the surgeon does not perform UDSs.

The UDS is an ancillary study that complements the anamnesis and physical examination of the patients with LUT alterations, allowing a documentation of the disorder's origin and determine the appropriate treatment.

1 Neurourology and Urodynamics 2017; 36(5):1243-1260

2 International Urogynecolgy Journal 2010; 21:5–26

Disclosure:

Work supported by industry: no.

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