Urodynamics

Urodynamics is a study that assesses how the bladder

and urethra are performing their job of storing and
releasing urine.
Urodynamic tests can help explain symptoms such as:
incontinence
frequent urination
sudden, strong urges to urinate but nothing comes out
problems starting a urine stream
painful urination
problems emptying the bladder completely
recurrent urinary tract infections

Specific tests:

Post-void residual volume

Uroflowmetry
Multichannel cystometry
Urethral pressure profilometry

Uroflowmetry

Uroflowmetry is a simple, diagnostic screening procedure used to

calculate the flow rate of urine over time. The test is noninvasive , and
may be used to assess bladder and sphincter function.
Uroflowmetry is performed by having a person urinate into a special
funnel that is connected to a measuring instrument. The measuring
instrument calculates the amount of urine, rate of flow in seconds, and
length of time until completion of the void. This information is
converted into a graph and interpreted by a doctor. The information
helps evaluate function of the lower urinary tract or help determine if
there is an obstruction of normal urine outflow.
During normal urination, the initial urine stream starts slowly, but almost
immediately speeds up until the bladder is nearly empty. The urine flow
then slows again until the bladder is empty. In persons with a urinary

tract obstruction, this pattern of flow is altered, and increases and

decreases more gradually.
Uroflowmetry measures the relationship between detrausor contraction
() and uretheral resistance() during voiding.

PARAMETER MEASURED
The following parameters are reflected by the
Uroflowmetry test
-> Voided volume (ml)
-> Maximum flow rate (ml/s)
-> Average flow rate (ml/s)
-> Voiding time (sec)
-> Flow time (sec)
-> Time to maximum flow (sec)
-> Hesitancy (sec)

VOIDED VOLUME :
The reproducibility and reliability of the maximum flow
rate is best with voided volumes between 200 ml & 400
ml. A reduced flow rate obtained at volumes smaller than
100 to 150 is unreliable in unobstructed cases the
maximum flow rate will rise proportionally to the square
root of the voided volume up to a volume determined by
the bladder capacity.

VOIDING TIME:
Total duration of micturition.

AVERAGE FLOW RATE :

Average flow rate is the voided volume divided by flow
time.

MAXIMUM FLOW RATE :

The maximum flow rate is the most important single
parameter in Uroflowmetry but interpretation of
maximum flow rate values requires familiarity with the
flow curve pattern, the voided volume ,age ,and sex.

Abnormal results in uroflowmetry:

Uroflowmetry can often be used to suggest the presence

of bladder outlet obstruction or a poorly functioning
detrusor muscle.
An interrupted curve can be seen in detrusor
sphincter dyssynergia.
A curve with high speed or short voiding time can be
seen in case of internal sphincter deficiency(poor
urethral resistance).
A curve with low speed can be seen in obstructive
causes.