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Urinary tract disorders
Published in Henry J. Woodford, Essential Geriatrics, 2022
Uroflowmetry is the measurement of the rate and volume of urine passed during micturition. This is achieved by passing urine into a specialised measurement device. It may be performed following cystometry with the bladder and rectal pressure transducers still in place. In this way, the bladder pressure generated can be matched with urine flow. An underactive bladder or a high pressure required to overcome outflow tract obstruction may be observed (seeFigure 11.6).
DRCOG OSCE for Circuit A Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
The three investigations that can be arranged as an outpatient in hospital include a pelvic ultrasound to exclude fibroids, and basic urodynamic investigations such as uroflowmetry and cystometry. Uroflowmetry involves the patient urinating on a flow meter and measuring how quickly the bottom is filled. Normal flow rate is 15 ml s-1 for > 150 ml. Cystometry measures rectal, bladder, and detrusor pressures and flow.
Neurourology, urodynamics, and urogynecology
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Matthew E Nielsen, E James Wright
Uroflowmetry provides information on the flow of urine from the urethra: Normal peak flow rates: 20–25 ml/s (male) and 20–30 ml/s (female)Shape of the curve itself can be informativeMechanical obstruction is typically reflected by prolonged flow time and sustained low flow rateAbsent detrusor activity is typically reflected by a sawtooth pattern of nonsustained spurts of reduced flow, reflecting abdominal straining.
Evaluation of boys with daytime incontinence by combined cystourethroscopy, voiding cystourethrography and urodynamics
Published in Scandinavian Journal of Urology, 2021
Lilia Winck-Flyvholm, Karen Damgaard Pedersen, Simone Hildorf, Jorgen Thorup
Between 2010 and 2018, we investigated 75 boys aged 5–14 (median age 9) years old according to a prospective set-up with cystourethroscopy including application of a suprapubic catheter in general anesthesia and within 24 h thereafter VCUG followed by urodynamic combined cystometry and pressure-flow study. All boys had daily problems with urinary incontinence, urgency and eventually frequency (more than seven times per day). The median number of daily voiding was 7 and 57% (43/75) of the boys had frequency. Nocturnal enuresis, defined as bedwetting at least once a month, was also noted in 46 boys. Prior to inclusion all boys had previously tried urotherapy for a period of 3 months to 5 years (median 1 year) and the minority (23%, 17/75) had additionally included periods of anticholinergic treatment with unsatisfactorily effect. The urotherapy regime included evaluation and regular monitoring with three days frequency volume charts, uroflowmetry and bladder emptying by ultrasonography. None of the boys had any previous episodes of urinary tract infection (UTI) recorded. None of the boys had neurological symptoms or abnormalities and none had obstructive flow pattern at repeated uroflowmetry. All the boys had normal upper urinary tract estimated by ultrasound examination. The boys had follow-up for 1 month to 9 years (median 2 years and 8 months).
Stepwise approach in the management of penile strangulation and penile preservation: 15-year experience in a tertiary care hospital
Published in Arab Journal of Urology, 2019
Sandeep Puvvada, Priyatham Kasaraneni, Ramesh Desi Gowda, Prasad Mylarappa, Manasa T, Kanishk Dokania, Abhishek Kulkarni, Vivek Jayakumar
The complications are described in Table 3. For three patients, SPC was needed as per urethral catheterisation was not possible. One patient lost to follow-up for 1 year had his SPC removed in a local hospital, he later presented back to us with urethro–cutaneous fistula (Figure 7) secondary to urethral stricture, SPC was repeated and after 3 months we excised the fistulous tract and he underwent anastomotic urethroplasty. The other patient had short segment stricture of the proximal penile urethra and he underwent visual internal urethrotomy. This patient is on regular follow-up with uroflowmetry. One patient presented with auto-amputation of penis with an infected wound over the detached penile site, so SPC was performed as a diversion procedure to allow healing followed by perineal urethrostomy after 1 month.
Long-term urodynamic findings following radical prostatectomy and salvage radiotherapy
Published in Scandinavian Journal of Urology, 2018
Maria Ervandian, Jens Christian Djurhuus, Morten Høyer, Charlotte Graugaard-Jensen, Michael Borre
The non-invasive uroflowmetry showed a prolonged flow in six patients that indicated the presence of infravescial obstruction, as a result of either bladder outlet obstruction or a poorly contractile detrusor muscle. With regard to the simultaneous measurement of bladder pressure and bladder function, 10 patients had a non-compliant bladder and detrusor overactivity, and involuntary contractions were present in seven patients. In the voiding phase, bladder outlet obstruction was present in seven patients with increased detrusor pressure and reduced flow rates; only three of the seven patients had signs of urethral stricture on their UPP. Based on the UPP, these results demonstrate a strong relationship between low MUP and daily urinary incontinence.