Urodynamics and the Evaluation of Female Incontinence

A practical primer for physicians wanting to learn about simple and complex urodynamic testing. The clear, concise workbook structure allows for quick reference to multichannel urodynamic tracings and their interpretation. Brief but thorough discussion of the underlying theory and concepts behind urodynamic testing enable readers to gain a firm grasp of the implications of test results in individual patients. It provides an understanding of all the techniques used for the evaluation and treatment of the incontinent or lower urinary tract dysfunctional female patient, and also includes a quick reference guide to outpatient treatment. In contrast to other didactic texts, this book allows readers to initiate testing programs and will thus be of practical benefit to all those interested in improving patient care.

Section I: Routine Office Evaluation.- 1 The Female Urologic History.- 2 Voiding Diaries.- 3 Uroflowmetry in the Female.- 4 The Lumbosacral Neurologic Examination.- 5 The Gynecologic Pelvic Examination.- 6 The Q-Tip Test.- 7 Urethral Calibration.- 8 Stress Testing.- 9 Pad Testing.- Section II: Cystourethroscopy and Cystometry.- 10 Dynamic Urethroscopy.- 11 Supine Urethroscope Cystometry.- 12 Cystoscopy.- 13 Standing Single Channel Cystometry.- Section III: Multichannel Urodynamics: Normal Studies.- 14 Who Needs Urodynamics?.- 15 Urethral Closure Pressure Profiles.- 16 Augmenting Urethral Closure Pressure Profiles.- 17 Dynamic Urethral Closure Pressure Profiles: Valsalva and Cough Profiles.- 18 Urethral Responses to Position Changes.- 19 Urethral Responses to Bladder Filling.- 20 Multichannel Urethrocystometry.- 21 Voiding Pressure Studies.- Section IV: Multichannel Urodynamics: Pathologic Studies.- 22 Genuine Stress Incontinence.- 23 Pressure Transmission Ratios.- 24 Detrusor Instability.- 25 The Acontractile Bladder.- 26 Detrusor Sphincter Dyssynergia.- 27 The Low Compliance Bladder.- 28 Genital Prolapse.- 29 The Low Pressure Urethra.- 30 Urethrovaginal Fistulas.- 31 Urethral Diverticula.- 32 Urethral Instability.- 33 Uninhibited Urethral Relaxation.- Section V: Special Tests.- 34 Prolapse Pessary Tests.- 35 Urethral Denervation Testing.- 36 Vesical Denervation Testing.- 37 The Bladder Cooling Test.- 38 The Stop lest.- 39 Pelvic Floor Stimulation: Effect on Detrusor Activity.- 40 Pelvic Floor Stimulation: Effect on Urethral Closure Pressure Profile.- 41 The Effect of Hypogastric Nerve Block on Detrusor Instability.- 42 The Effect of Pudendal Block on the Urethral Closure Pressure Profile.- 43 Leak Point Pressure Testing.- Section VI: Urodynamic Artifacts.- 44 Rectal and Vaginal Peristalsis.- 45 Transducer Placement and Poor Calibration.- 46 Filling Catheter Artifacts.- 47 False Negative Cough Profiles.- 48 Transducer-Induced Artifacts.- Section VII: Postoperative Urodynamics.- 49 The Effect of Retropubic Urethropexy on the Resting Urethral Closure Pressure Profile.- 50 The Effect of Retropubic Urethropexy on the Dynamic Urethral Closure Pressure Profile.- 51 The Effect of the Suburethral Sling Procedure on the Dynamic Urethral Closure Pressure Profile.- 52 Postoperative Detrusor Instability.- 53 Type III Stress Incontinence.- Appendices.- Appendix A Office Treatment of Urinary Incontinence.- Appendix B Terminology of Lower Urinary Tract Function.- Appendix C Recording Forms for Urodynamics and Evaluation of Urinary Dysfunction.- Appendix D Self Test.