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Multiple Sclerosis, Transverse Myelitis, Tropical Spastic Paraparesis, Progressive Multifocal Leukoencephalopathy, Lyme Disease
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Michele Fascelli, Howard B. Goldman
The purpose of urodynamic testing is to determine and classify the voiding dysfunction and to identify risk factors such as DESD, decreased bladder compliance, and high detrusor filling pressures. Predisposing factors to upper tract problems include vesicoureteral reflux, bladder and kidney stones, hydronephrosis, pyelonephritis, and renal insufficiency. A retrospective analysis of 66 MS patients revealed no predictive urodynamic parameters for upper tract deterioration as identified by ultrasound.29,30
Urogynaecology and pelvic floor problems
Published in Helen Bickerstaff, Louise C Kenny, Gynaecology, 2017
The purpose of urodynamic testing is to reproduce a micturition cycle (bladder filling and voiding) while recording abdominal and bladder pressure and attempting to reproduce the patient’s symptoms, to provide a diagnosis.
Benign prostatic hyperplasia and lower urinary tract symptoms in men with neurogenic bladder
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Jeffrey Thavaseelan, Akhlil Hamid
In a typical patient with diabetes, urodynamic testing often demonstrates lack of sensation on filling with an occasional moderate increase in detrusor pressure. There is often prolonged voiding with relatively low peak flow and residual urine. Therefore, it is important to recognize that in patients with diabetes, DO and detrusor underactivity may coexist leading to a confusing combination of symptoms of urgency, frequency, and incomplete emptying. Therefore, the management of LUTS in this group of patients should be tailored on an individual basis. Poor glycemic control needs to be addressed as this may increase urine output and therefore incontinence, frequency, and urgency. Bladder retraining should be introduced (e.g., scheduled voiding every 3 to 4 hours) to minimize the impact of reduced bladder sensation. Significant residual urine complicated by renal impairment and UTI should be treated with intermittent self-catheterization. When BPH is thought to contribute to the overall symptoms, it is important that the abovementioned measures are introduced, and TURP performed only in the event failure of less invasive treatments. Alpha blockers and/or 5ARIs should be used in conjunction with other measures when appropriate.
Diastolic blood pressure changes during episodes of autonomic dysreflexia
Published in The Journal of Spinal Cord Medicine, 2021
Steven Kirshblum, Fatma Eren, Ryan Solinsky, Kathryn Gibbs, Katharine Tam, Robert DeLuca, Todd Linsenmeyer
After approval by the Institutional Review Board, retrospective chart reviews were conducted for individuals who had consecutive urodynamic examinations from August 2018 to January 2019. Inclusion criteria consisted of a traumatic SCI, neurological level of injury ≥T6, age 18 years and above, and duration of injury of at least 3 months. In individuals who met the inclusion criteria, up to 10 years of prior urodynamic testing were reviewed. AD was defined as SBP >20 mmHg from their baseline blood pressure according to the current definition of the ISAFSCI.1 Data collected for each individual included age, sex, date of urodynamic examination, duration of injury from the most recent study, neurological level of injury, and the American Spinal Cord Injury Association (ASIA) Impairment Scale (AIS) according to International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients.23
Evaluation and treatment of urinary incontinence in the aging male
Published in Postgraduate Medicine, 2020
Urodynamics may be useful in men with UI, particularly those who have failed therapy, have underlying neurological condition, have comorbid condition(s) that may cause LUTS, and/or patients considering genitourinary reconstruction [53]. Urodynamic testing provides helpful information regarding the storage phase (detrusor activity, bladder sensation, bladder capacity, compliance, urethral function), as well as the voiding phase (detrusor activity, urethral function). Testing can be particularly helpful to assess for uninhibited contractions, UUI, SUI, evidence of bladder outlet obstruction versus underactive bladder, reduced bladder compliance, and reduced bladder capacity, all of which may contribute to UI. Ability of older adults to tolerate urodynamic testing, follow directions, and adequately participate may be compromised in those with cognitive impairment and/or mobility issues [46].
Pelvic floor dysfunction in midlife women
Published in Climacteric, 2019
SUI, UUI, and even OAB are terms that refer to symptoms reported by patients. Although a classification of incontinence by symptoms alone is imperfect, it is easy, clinically useful, and cost-effective. Symptoms alone can help determine treatment paths and define the impact on quality of life. Urodynamic testing is performed for objective diagnosis and is often used prior to surgery. Such testing defines urodynamic stress incontinence as objective urine loss with increased intraabdominal pressure in the absence of a detrusor contraction. This objective finding would be expected in most women complaining of SUI. Urodynamics additionally objectively define the condition of detrusor overactivity, a bladder dysfunction with uninhibited detrusor muscle contractions (with or without urine loss) on bladder filling in the absence of infection or the obvious bladder pathology. Detrusor overactivity is most often associated with UUI and/or OAB symptoms.