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.

Fulfilling 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.

micturition 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 hypermobility 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 gray in “ 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 ` ` stressful  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 _