Urodynamic examinations

Uroflowmetry (UFM)

 * Non-invasive measurement flow rate urine ( amount urine for time − Q = ml/s);
 * if pathological results we indicate a PQ study ;
 * for execution this examination is needed sufficient micturition volume (at least 150 ml);
 * depends on quality detrusor, fill bladder, patency throats and urethras;
 * patient urinate into specially adjusted toilets, urine turns out on constantly a rotating disk that is a stream urine braked − quantity energy needed to maintain constant the rotation is direct proportionately weight falling urine;
 * on curves we evaluate:
 * whether the flow is continuous or dashed;
 * maximum flow (maximum flow rate, Qmax) − men above 15 ml/s, women above 20 ml/s;
 * average flow;
 * further timewise delay between the beginning efforts to micturition and the beginning micturition (up to 5 s), shape ascending parts, time achievement maximal micturition (steep), volume micturition, total time, average flow rate, total face curves;
 * Qmax < 12ml/s means obstruction whose hypoactivity urinary bladder.

Filling cystometry

 * We determine value detrusor pressure during fulfillment urinary bladder by catheter (Pdetrusor = Pves − Pabd);
 * during examination an intravesical and rectal catheter is inserted;
 * intravesical catheter measures intravesical pressure;
 * rectal catheter measures abdominal pressure.
 * At examination we evaluate:
 * sensitivity of the detrusor − patient indicates feeling the first, normal and strong compulsion on urine These information they are considered with maximum capacity urinary bladder;
 * activity of the detrusor − for physiological conditions does not occur during fulfillment of the so-called uninhibited contractions of the detrusor, which manifest themselves sudden and wavy rise pressure;
 * capacity of the detrusor − in an adult human is normal capacity bladder between 350–500 ml;
 * compliance of the detrusor − describes compliance walls urinary bladder. This is a share volume and change pressure (ml/cm H2O). Physiological value is approximately 20 ml/cm H2O.

Miction cystometry

 * Otherwise also manometric-flow study, pressure-flow study, PQ study, simultaneous urodynamic entry  ;
 * we determine detrusor pressure during micturition;
 * this is dynamic examination with record current urine, intravesical pressure during micturition and intra-abdominal pressure ;
 * indicated from differentially diagnostic reasons for:
 * benign hyperplasia prostate and weak current on UFM to reduced contractility detrusor;
 * irritating micturition symptomatology and strong current on UFM to rule out obstruction lower ones honor urinary.

Determination of Leak point pressure
It has two forms.
 * Determination values intravesical pressure, at which occurs escape urine from the bladder.

Abdominal

 * the so- called valsalva (LPP–VLPP);
 * we measure help rectal catheter;
 * for diagnostics stressful incontinence (used therefore especially in women);
 * Mon application rectal catheter we invite the patient to cough (Valsava's maneuver), and we observe whether and at what kind pressure runoff occurs urine;
 * if value abdominal pressure is at incontinence higher than 90 cm H2O, this is probably hypermobile urethras;
 * if value abdominal pressure is at incontinence less than 60 cm H2O, this is most likely an insufficiency urethral sphincter;
 * values between 90 and 60 cm H2O are in a “gray zone”.

Detrusor

 * The so- called BLPP (bladder leak point pressure);
 * the catheter is in the urinary tract bladders;
 * examination is indicated at risk vesicoureteral reflux, e.g. in children with congenital developmental defects;
 * values above 40 cm H2O (in children above 40 cm H2O) are unfavorable from the point of view emergence megaureters.

Profilometry

 * At sliding out measuring catheter constant at blistering speed we record pressure in the urethra;
 * or urethral pressure profile;
 * not performed routinely ;
 * at use stressful of maneuvers (cough) is stress profilometry.

Videourodynamics

 * Combination filling cystometry and PQ study with rtg cystography, or ultrasonography ;
 * most complex, however laborious, that's why it's not done often