Urodynamics: Physiological Background, Set-Up, Calibration & Artifacts

Posted by Clark Love on Apr 2, 2018 7:24:48 PM

 

Introduction:

Urodynamics (UDS) is an interactive diagnostic study of lower urinary tract function. It is composed of several tests that can be used to obtain functional information about urine storage and expulsion. Its main goal is to reproduce the patients’ symptoms and determine their cause.

The present article is a review of the physiological concepts behind UDS, and explains the various normal and abnormal forces and parameters that are measured and used during the tests to assist the physician in making a diagnosis. It outlines the importance and methods of the calibration of UDS equipment to optimize diagnostic accuracy and reliability, which would have a crucial impact over the treatment’s decision, and consequently the patient’s outcome.

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Topics: urodynamics

Reappraising Anorectal Manometry  in Patients With Fecal Incontinence

Posted by Clark Love on Mar 27, 2018 4:05:03 PM

 canstockphoto38128481-1Anorectal function tests are usually performed in patients with fecal incontinence who have failed typical, conservative treatment. This study, which we are going to discuss right now, was aimed to determine the additive value of performing anorectal function tests in such patients in selecting them for surgery.

Introduction

Fecal incontinence is the inability to voluntarily control bowel movements causing stool to leak from the rectum, unexpectedly. It is a very disabling condition with a prevalence of roughly 6% in the adult population. Causes of FI are:

  • Disruption of the anal sphincters secondary to obstetric or surgical trauma;
  • Neuropathy such as multiple sclerosis diabetes mellitus;
  • Neurologic deterioration related to nervus pudendus injury due to chronic straining during chronic constipation or delivery
  • Decreased rectal capacity due to inflammatory bowel disease, radiation proctitis and/or irritable bowel syndrome, diarrhea, the physical inability to reach toilet facilities, and highly reduced mental awareness.
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Topics: Anorectal Manometry Testing, Anorectal Manometry

The Efficacy of Botulinum Toxin a and Sacral Neuromodulation in the Management of Interstitial Cystitis/Bladder Pain Syndrome

Posted by Clark Love on Mar 14, 2018 10:58:16 PM

 

The following article is based on a study which addresses the evidences available in the medical literature on the efficacy of Botulinum Toxin A (BoNT-A) and sacral neuromodulation (SNM) in patients suffering from interstitial cystitis (IC)/bladder pain syndrome (BPS). We will discuss this study to identify the mechanism of action and draw a clear conclusion based on the clinical efficacy of both therapies.

Introduction

The terms interstitial cystitis and bladder pain syndrome are used side by side. IC/BPS is often used like this in the medical world, boasting symptoms such as urinary frequency, urgency and bladder pain, pressure and/or discomfort in the absence of other pathological findings. Current management aims to decrease symptoms such as bladder pain and lower urinary tract (LUT) symptoms.

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Topics: interstitial cystitis, SNM, BoNT-A, Botulinum Toxin A, sacral neuromodulation, bladder pain syndrome, botox

Water vs Air Charged Transducer Catheter Pressures in The Evaluation of Cystometrogram & Voiding Pressure Studies

Posted by Clark Love on Mar 2, 2018 1:03:17 PM

In the following article we are going to summarize this study. The aim of this research paper is to present facts and data to state that simultaneous pressure measurements with WP and AC in a single catheter will provide analogous pressures for Valsalvas, coughs, and maximum pressures in voiding pressure studies (VPS).

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Topics: urodynamics catheters

How Can We Maximize The Diagnostic Utility Of Uroflow?

Posted by Clark Love on Feb 12, 2018 12:40:16 PM

Uroflow ChartHow can we gauge the current level of diagnostic utility of uroflowmetry? Are there areas needing research to improve it? This study was performed to verify the diagnostic value of uroflowmetry, its flaws, to discuss gaps in knowledge, and to provide areas where further research is necessary.

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Topics: Uroflow, Uroflowmetry

How to Interpret Conventional Anorectal Manometry

Posted by Clark Love on Feb 5, 2018 8:04:00 AM
Anorectal Manometry

Anorectal manometry is a widely-available, economical and precise test for establishing the functional competency of the rectum and the anal canal. It plays an essential role in the diagnosis of functional defecatory disorders such as constipation, fecal incontinence and Hirschsprung disease in children.

This test involves the assessment of two major functions of the anorectal system. The resistive system – continence; and the capacitive system – defecation. Continence and defecation are the two most important roles played by the anorectal system. Quantitative assessment of the anal sphincter tone by anorectal manometry helps find the etiology of anorectal disorders. In the following article, we are going to discuss briefly how to interpret conventional anorectal manometry.

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Topics: Anorectal Manometry

Arе Urodynamic Prосеdurеѕ On The Rise?

Posted by Clark Love on Jan 23, 2018 3:28:44 PM

Urology and Urodynamics - Is Urodynamics on the Rise?Most of the urodynamic literature is currently focused on the indications for urodynamic studies for treatment of voiding dysfunction and urinary incontinence. In reality, much less is known about the frequency with which urodynamic procedures are being performed and trends in the practice among urologists. In the following article, we will talk about trends in the practice of urodynamic procedures among urologists in the last decade and we will try to find what factors impacting growth. We compared relevant studies and put together the information to assess the utilization of urodynamic  procedures.

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Topics: urodynamics staffing, urology, urodynamics service provider

Ambulatory vs. Traditional Urodynamics in Spinal Cord Injuries

Posted by Clark Love on Jan 9, 2018 11:14:24 AM

Ambulatory Urodynamics vs Traditional UrodynamicsBladder management is a hugely important factor that needs to be taken into consideration when it comes to managing patients with spinal cord injury (SCI). In the following blog post, we will discuss differences between ambulatory urodynamics and conventional urodynamics on patients with SCI.

According to this article1, conventional urodynamic testing has multiple drawbacks mainly due to the unfamiliar circumstances for the individual, immovability of the instrument, expenses, restrictive position during the test as well as manual filling of the bladder (rather than natural filling). Therefore, fully ambulatory urodynamic monitoring systems have been developed, which enable the pressure in the abdomen to be measured in a perfectly non-invasive manner. The question is: how reliable are they and can we use the findings effectively?

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Topics: urodynamics, ambulatory urodynamics

Why Urodynamics & UroCuff Tests Are Appropriate For Health Care Today

Posted by Clark Love on Dec 22, 2017 11:58:58 AM

In the US, over 17 million people suffer from daily urinary incontinence. When discussing the prevalence of incontinence, women are more predisposed to this condition. To get a better grasp on the seriousness of urinary incontinence, take a look at some facts:

  • Between the ages of 30 and 59, one in four women has had an episode of urinary incontinence
  • More than 50% of elderly people which are living at home or placed in specialized facilities have urinary incontinence
  • The good news is that 80% of those affected by urinary incontinence can be cured, or have their life improved.

 

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Topics: Urodynamics Testing, UroCuff

Bladder Cancer and Incontinence

Posted by Clark Love on Nov 30, 2017 10:53:35 AM

Bladder cancer is a relatively rare phenomenon in the United States – affecting fewer than 200,000 Americans annually – but can be serious when left untreated. Here, incontinence will be discussed relative to bladder cancer, which is a side effect of both the cancer itself and the treatment.

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Topics: incontinence, Bladder Cancer

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