Urodynamic examination

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The urodynamics is an examination method in which with the help of pressure sensors and electrodes the functioning of the urinary bladder is examined ( bladder pressure measurement ). It is used in urology and pediatric urology .

Investigation process

During the examination, a special pressure measuring catheter is inserted into the bladder and into the rectum . After the initial emptying of the bladder, it is then filled with infusion solution at body temperature through the catheter and at the same time the pressure inside the bladder is measured through a second channel. The second pressure sensor, which is inserted into the anus, measures the pressure that acts on the bladder from outside, e.g. B. when the patient presses or coughs. This enables the pressure difference between the bladder and the abdominal cavity to be determined. The activity of the pelvic floor muscles, including the bladder sphincter, is measured by three adhesive or needle electrodes. For standard examinations on adults and children, only adhesive electrodes should be used. If the patient can sit sufficiently, the examination takes place on a special toilet chair. On the stool, a collection mechanism located underneath it measures whether and how much urine the patient involuntarily loses while filling the bladder and how much urine is released when the bladder is finally emptied. In so-called video urodynamic examinations (obligatory for cross-sectional patients), X-ray contrast media is used to fill the urinary bladder and a urodynamic measurement can be performed at the same time as a urodynamic measurement if an X-ray examination unit is available (contrast media X-ray of the urinary bladder) . The examination takes between 30 minutes and 1 hour, depending on the extent of the examinations carried out and the capacity of the bladder.

All measured values ​​are continuously documented and recorded. The pressure and flow curves obtained in this way are evaluated and interpreted by the examiner with the support of a computer system.

Diagnostic statements

With this examination technique, the various bladder dysfunction such as urinary incontinence , over and underactive bladder, neurogenic bladder disorder, etc. can be differentiated and divided into degrees of severity. In addition, the corresponding X-ray examination ( MCU ) serves to show the morphological representation of the lower urinary tract and to detect or exclude vesicorenal reflux . The examination technique is required when non-invasive examinations cannot unequivocally clarify the cause of a bladder dysfunction. However , regular urodynamic examinations are particularly indicated for the diagnosis and control of the neurogenic bladder .

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