Abrams' Urodynamics

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Cover Title Page Copyright Page Contents Abbreviations Contributors Preface First Foreword Second Foreword Part I Basic Principles Chapter 1 Basic Urodynamics and Fundamental Issues Introduction to Urodynamics Basics of Urodynamics Fundamentals A Brief History of Urodynamics Summary References Chapter 2 Applied Anatomy and Physiology Introduction Upper Urinary Tract The Urinary Bladder The Male Urethra The Female Urethra The Pelvis Nervous System Control of the Lower Urinary Tract References Chapter 3 The Physics of Urodynamic Measurements Measurement of Pressure Measuring Pressure in Urodynamics Measuring Pressure Correctly; Setting Zero (Reference) Pressure and Calibrating Measuring Infused Volume Measuring Flow Rate References Part II Functional Urology Chapter 4 Patient Assessment Patient-Reported Outcome Questionnaires FVCs and Bladder Diaries Medical History Physical Examination Other Investigations References Chapter 5 Treatments for Lower Urinary Tract Dysfunction Storage Phase Problems Voiding Problems Post-Micturition Symptoms References Part III Urodynamic Techniques Chapter 6 Uroflowmetry How to Do the Test Reporting a Test Result Interpretation Equipment Summary References Chapter 7 Cystometry and Pressure-Flow Studies Principles of Cystometry Technique of Filling Cystometry Voiding Cystometry; Pressure-Flow Studies Electromyography References Chapter 8 Video Urodynamics Anatomical and Physiological Observations During VUDS Roles of VUDS in Men Roles of VUDS in Women VUDS in People with Neurological Disease and Children Renal Failure and Transplant Patients Whitaker Testing Using VUDS to Understand Limitations of Pressure Recording Equipment Needed Considerations when Using X-rays Performing the Test Advantages and Disadvantages of VUDS Alternatives to VUDS References Chapter 9 Ambulatory Urodynamics Indications for AUDS Technique of AUDS Analysis References Chapter 10 Studies Assessing Urethral Pressures Static Urethral Pressure Profilometry Interpreting the UPP The ‘Stress’ Urethral Profile Urethral Leak Point Pressure Measurement Indications for Urethral Function Testing References Chapter 11 Non-invasive Urodynamics Introduction Non-invasive Urodynamic Techniques The Penile Cuff Test Practicalities of the Penile Cuff Test Current Standing References Part IV Urodynamics in Clinical Practice Chapter 12 Urodynamics in Children Children with Neurological Disorders Children with Non-neurological Disorders Practical Aspects of Urodynamic Studies Summary and Recommendations References Chapter 13 Urodynamics in Women Stress Urinary Incontinence Overactive Bladder Urethral Relaxation Incontinence Mixed Urinary Incontinence Mixed Incontinence (Urinary and Faecal ‘Double’ Incontinence) Situational Incontinence; Coital/Orgasm Leakage and Giggle Incontinence BOO and Detrusor Underactivity (DUA) Urinary Infections and Inflammation Conclusions References Chapter 14 Urodynamics in Men Men with LUTS Post-Prostatectomy Symptoms Special Situations References Chapter 15 Structural Changes of the Bladder Outlet Impaired Blood Supply to the Bladder Outlet Trauma Hypospadias Surgical Mesh Gender Confirmation Surgery References Chapter 16 Neurological Disease and LUTS Impaired Neurological Control of the Lower Urinary Tract: General Principles Understanding the Neurological Situations Life-Threatening Issues in NLUTD Assessment of LUTS in Neurological Disease Urodynamic Observations Urodynamic Technique in the Neurogenic Patient NLUTD Treatment Specific Neurological Diseases Assisting Neurology and Neurosurgery Teams in Defining the Neurological Lesion References Chapter 17 Urodynamics in Older People Understanding and Evaluating Frailty The Management Pathway in Older People Patterns of LUTS in Older People Therapy Decisions References Part V Running a Urodynamics Unit Chapter 18 Troubleshooting During Urodynamics Uroflowmetry Filling Cystometry Pressure-Flow Studies Conclusions References Chapter 19 Artefacts in Urodynamics Artefacts During Flow Artefacts During Filling Cystometry Artefacts During Pressure-Flow Studies References Chapter 20 Anorectal Physiology Anorectal Physiology Conservative Treatment Management of Colorectal Pelvic Floor Patients Faecal Incontinence Psychological Distress and Quality of Life Future Direction of Colorectal Pelvic Floor Surgery References Chapter 21 Organisation of the Urodynamic Unit Patient Referral The Patient’s Hospital Attendance Planning a New Urodynamic Service Reference Chapter 22 Equipment Maintenance Routines and Regular Checks Procurement Reference Chapter 23 Working with Limited Resources Clinical Issues Equipment Maintenance Requirements Teaching Chapter 24 Research Evidence on the Clinical Role of Urodynamics References Appendix A Key Patient Assessment Metrics from the International Consultation on Incontinence Questionnaires (ICIQ) ICIQ-FLUTS ICIQ-MLUTS ICIQ-BD Appendix B Fundamentals Documents from the International Continence Society N&U 2018 Volume 37 Supplement 6 Appendix C Patient Information Leaflets from the Bristol Urological Institute Appendix D Practice, Standards, and Equipment Recommendations International Consultation on Incontinence 2016; Executive Summary: Urodynamic Testing United Kingdom Continence Society: Minimum standards for Urodynamic Studies, 2018 UK Centre for Evidence Based Purchasing; Buyers’ Guide Urodynamics Systems Good Urodynamic Practices Documents from the International Continence Society Index EULA "Urodynamics has two basic aims: To reproduce the patient's symptomatic complaints while making key observations. To provide a pathophysiological explanation by correlating the patient's symptoms with the urodynamic findings. These two basic aims are crucial to the purpose of urodynamics - essentially it is a diagnostic test that will aid in the management of patients. The need to make urodynamic observations reflects the fact that the patient's symptoms are important, but they might be somewhat misleading. Most patients with lower urinary tract dysfunction (LUTD) present to their doctor with symptoms. However, lower urinary tract symptoms (LUTS - Table 1) should not simply be taken at face value, since a range of differing mechanisms may result in rather similar symptomatic presentations. The statement "the bladder is an unreliable witness" (1) reflects how symptoms are the starting point, but do not actually identify the ultimate explanation. Since treatment should correct the underlying cause, it is necessary to identify mechanisms, avoiding assumption or prejudice coming from taking symptoms at face value. An excellent example of this is voiding LUTS in men, where the cause on urodynamic testing may prove to be bladder outlet obstruction (BOO) and/or detrusor underactivity (DUA); BOO should respond fully to surgery to relieve obstruction such as transurethral resection of prostate (TURP), while such surgery is potentially not helpful in the second (2). Voiding LUTS in males are of unreliable diagnostic value, and only slow stream and hesitancy show any correlation with the urodynamic findings of BOO (3-5). Even with flow rate assessment, one cannot be sure whether BOO is present [Figure 1.1]. The difficulty of assessing LUTD by symptoms alone is the uncertainty about establishing truly what is going on in the individual describing them"-- Provided by publisher A practical guide to all aspects of urodynamic investigation and its role in modern health care Urodynamic testing is an ever-advancing field with applications in the management of patients from across a wide range of clinical areas. Bringing together fundamental principles and cutting-edge innovations, Abrams’ Urodynamics has been designed as an all-in-one guide to Functional Urology and Urogynecology, offering direct, up-to-date instruction on how to best perform and understand urodynamic tests within the overall treatment pathway. Its chapters cover everything from everyday basic practice to advanced complex cases, and are enhanced with more than 450 helpful illustrations. Including numerous revisions and new features, this fourth edition of the book boasts: Coverage of all investigative approaches, including uroflowmetry, cystometry, video-urodynamics, and non-invasive techniques Details on the successful running of a urodynamic unit, with information on organizational issues, equipment set-up, and common problems and pitfalls Sections addressing children, women, men, the elderly, and neuropaths Extensive description of International Continence Society (ICS) Standards throughout Appendices that include ICS Standards and Fundamentals documents, ICIQ modules and Patient Information Leaflets With its wealth of clinical tips, illustrations, new innovations, and hands-on advice, Abrams’ Urodynamics is essential reading for all those wishing to better integrate urodynamic testing into their daily practice. Abrams'Urodynamics A complete guide to urodynamic investigation in modern health careUrodynamic testing is an ever-advancing field with applications in the management of patients from across a wide range of clinical areas. Bringing together fundamental principles and cutting-edge innovations, Abrams'Urodynamics has been designed as an all-in-one guide to Functional Urology and Urogynecology, offering direct, up-to-date instruction on how to best perform and understand urodynamic tests within the overall treatment pathway. Its chapters cover everything from everyday basic practice to advanced complex cases, and are enhanced with more than 450 helpful illustrations. Including numerous revisions and new features, this fourth edition of the book boasts:Coverage of all investigative approaches, including uroflowmetry, cystometry, video-urodynamics, and non-invasive techniquesDetails on the successful running of a urodynamic unit, with information on organizational issues, equipment set-up, and common problems and pitfallsSections addressing children, women, men, the elderly, and neuropathsExtensive description of International Continence Society (ICS) Standards throughoutAppendices that include ICS Standards and Fundamentals documents, ICIQ modules, and Patient Information LeafletsWith its wealth of clinical tips, illustrations, new innovations, and hands-on advice, Abrams'Urodynamics is essential reading for all those wishing to better integrate urodynamic testing into their daily practice.