Urodinamica abc

URODINAMYCS: a prime for the beginner by GIANCARLO VIGNOLI, MD Urodynamics and Urogynecological Unit Casa “Madre Fortunata Toniolo” Bologna

Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Micturition cycle: filling ,[object Object]

Micturition cycle: voiding ,[object Object]

Related events ,[object Object]

[object Object],[object Object]

No–instruments urodynamics ,[object Object],[object Object]

Patient clinical assessment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patient Sheet Front Page ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Questionnaires * ,[object Object],[object Object],[object Object]

Types of Bladder Diary ,[object Object],[object Object],[object Object]

Informations derived from Bladder Diary ,[object Object],[object Object],[object Object],[object Object]

1-hour Pad Test ( positive > 5 gr) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Vaginal Examination ( Inspection )

Vaginal Examination ( Stress Test )

POP-Q iuga simplified version ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Focused Neurological Examination ,[object Object],[object Object],[object Object]

Flow Recorders ,[object Object],[object Object]

Qmax : Normal Ranges Males under 40 years: > 21 mL/sec Females under 50 years: > 25mL/sec Males 40-60 years: > 18 mL/sec Females over 50 years: > 18 mL/sec Males over 60 years: > 13 mL/sec

Male Free Flowmetry Predictive Value ,[object Object],[object Object],[object Object]

Flow Nomograms ,[object Object],[object Object]

Pediatric Flow Nomograms ( < 14 y.o.)

Post-Voiding Residual (Ultrasounds & Bladder Scan)

Post- Voiding Residual : Normal Ranges ,[object Object],[object Object],[object Object],[object Object],[object Object]

Abdominal straining or Detrusor – Sphincter dyssinergia

Common artefacts ,[object Object],[object Object]

Invasive Urodynamics Cystometry & Pressure/Flow study

Clinical Preparation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Examination Chair ,[object Object]

Catheters ,[object Object],[object Object]

Air-charged catheter ( Laborie Medical Technologies) ,[object Object],[object Object],[object Object],[object Object]

Subtraction Cystometry pdet = pves-pabd ,[object Object]

Common artefacts ,[object Object]

Types of EMG ,[object Object],[object Object],[object Object],[object Object],[object Object]

Patch (surface) EMG electrodes for females and males The kinesiological EMG ,[object Object]

Placement of wire electrodes in female The neurophysiological EMG ,[object Object]

Placement of wire electrodes in male The neurophysiological EMG ,[object Object]

EMG-Interpretation ,[object Object],[object Object],[object Object],[object Object]

The procedure in 10 steps ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Assessment of Compliance ,[object Object],[object Object],[object Object]

Phasic contractions - Good sphincter control OAB - dry

Phasic contractions - Poor sphincter control OAB - wet

Terminal contractions - Poor brain control

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Urodynamic stress incontinence

[object Object],[object Object],[object Object]

Leak Point Pressure ,[object Object],[object Object]

Bladder filled at 200 ml ,[object Object],[object Object],[object Object],[object Object],[object Object]

Mixed urinary incontinence ,[object Object]

Male bladder outlet obstruction

[object Object],[object Object],[object Object],[object Object],[object Object]

PRESSURE/ FLOW ANALYSIS ICS Nomograms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Non-invasive BOO analysis ,[object Object],[object Object]

Pediatric dysfunctional voiding

Pseudodyssinergia in a boy with recurrent UTI

Neurogenic Bladder Source:YASUHIKO IGAWA, ICS 2007

Special Clinical Scenario: Spinal Cord Injury ,[object Object]

Symptoms of Autonomic Dysreflexia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

When doing urodynamics on a patient with potential risk for autonomic dysreflexia: ,[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Videourodynamics set-up ,[object Object],[object Object]

Neurogenic Bladder – Type 2 dyssinergia

Neurogenic bladder – Types 3 dyssinergia 4th degree reflux on the left

Types of Profilometry ,[object Object],[object Object],[object Object]

Step-by-step procedure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Urethral closure pressure ( ucp ) ,[object Object],[object Object]

MUCP Normal Values ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

The stress urethral profile ,[object Object],[object Object],[object Object],[object Object]

Urodinamica abc

Urodinamica abc

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Editor's Notes