| 词条 | Urodynamic testing |
| 释义 |
| name = Urodynamic testing | image = Image:Illu bladder.jpg|thumb| | caption = Urinary bladder | pronounce = | purpose = storing and releasing urine analysis | test of = | based on = | synonyms = | reference_range = | calculator = | DiseasesDB = | ICD10 = | ICD9 = | ICDO = | MedlinePlus = | eMedicine = | MeshID = | OPS301 = | LOINC = }} Urodynamic testing or 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:
Urodynamic tests are usually performed in Urology, Gynecology, OB/GYN, Internal medicine, and Primary care offices. Urodynamics will provide the physician with the information necessary to diagnose the cause and nature of a patient's incontinence, thus giving the best treatment options available. Urodynamics is typically conducted by urologists or urogynecologists. Purpose of testingThe tests are most often arranged for men with enlarged prostate glands, and for women with incontinence that has either failed conservative treatment or requires surgery. Probably the most important group in whom these tests are performed are those with a neuropathy such as spinal injury. In some of these patients (dependent on the level of the lesion), the micturition reflex can be essentially out of control and the detrusor pressures generated can be life-threatening. Symptoms reported by the patient are often an unreliable guide to the underlying dysfunction of the lower urinary tract. The purpose of urodynamics is to provide objective confirmation of the pathology that a patient's symptoms would suggest. For example, a patient complaining of urinary urgency (or rushing to the toilet), with increased frequency of urination can have overactive bladder syndrome. The cause of this might be detrusor overactivity, in which the bladder muscle (the detrusor) contracts unexpectedly during bladder filling. Urodynamics can be used to confirm the presence of detrusor overactivity, which may help guide treatment. An overactive detrusor can be associated with urge incontinence. The American Urogynecologic Society does not recommend that urodynamics are part of initial diagnosis for uncomplicated overactive bladder.[2] Specific testsThese tests may be as simple as urinating behind a curtain while a doctor listens, but are usually more extensive in western medicine. A typical urodynamic test takes about 30 minutes to perform. It involves the use of a small catheter used to fill the bladder and record measurements. What is done depends on what the presenting problem is, but some of the common tests conducted are;
StandardizationMales with benign prostate hyperplasia are influenced by voiding position: in the sitting position, the PVR, Qmax and TQ were shown to improve.[6] Apart from the possibilities in the management of this condition, it shows that measurements of urodynamics should be performed in a standardized position, else false-positive or negative findings may be found.{{citation needed|date=September 2014}} References1. ^{{cite journal |vauthors=van Leijsen SA, Kluivers KB, Mol BW, etal |title=Protocol for the value of urodynamics prior to stress incontinence surgery (VUSIS) study: a multicenter randomized controlled trial to assess the cost effectiveness of urodynamics in women with symptoms of stress urinary incontinence in whom surgical treatment is considered |journal=BMC Women's Health |volume=9 |issue= |pages=22 |year=2009 |pmid=19622153 |pmc=2722584 |doi=10.1186/1472-6874-9-22 |url=http://www.biomedcentral.com/1472-6874/9/22}} 2. ^{{Citation |author1 = American Urogynecologic Society |date = May 5, 2015 |title = Five Things Physicians and Patients Should Question |publisher = American Urogynecologic Society |work = Choosing Wisely: an initiative of the ABIM Foundation |page = |url = http://www.choosingwisely.org/societies/american-urogynecologic-society/ |accessdate = June 1, 2015}}, which cites: *{{cite journal|last1=Gormley|first1=EA|last2=Lightner|first2=DJ|last3=Faraday|first3=M|last4=Vasavada|first4=SP|title=Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline Amendment.|journal=The Journal of Urology|date=May 2015|volume=193|issue=5|pages=1572–80|pmid=25623739|doi=10.1016/j.juro.2015.01.087}} 3. ^{{cite journal |vauthors=Truzzi JC, Almeida FM, Nunes EC, Sadi MV |title=Residual urinary volume and urinary tract infection--when are they linked? |journal=J. Urol. |volume=180 |issue=1 |pages=182–5 |date=July 2008 |pmid=18499191 |doi=10.1016/j.juro.2008.03.044 |url=http://linkinghub.elsevier.com/retrieve/pii/S0022-5347(08)00601-0}} 4. ^{{cite journal |vauthors=Chang SJ, Yang SS |title=Variability, related factors and normal reference value of post-void residual urine in healthy kindergarteners |journal=J. Urol. |volume=182 |issue=4 Suppl |pages=1933–8 |date=October 2009 |pmid=19695621 |doi=10.1016/j.juro.2009.02.086 |url=http://linkinghub.elsevier.com/retrieve/pii/S0022-5347(09)00478-9}} 5. ^{{cite web |url=http://www.meddean.luc.edu/depts/urology/html/urodynamped.htm |title=loyola Univ. Health Sys. - Urology - Health Topics/Urodynamic Testing |work= |accessdate=}} 6. ^{{cite journal|last1=de Jong|first1=Y|last2=Pinckaers|first2=JH|last3=Ten Brinck|first3=RM|last4=Lycklama À Nijeholt|first4=AA|last5=Dekkers|first5=OM|title=Urinating Standing versus Sitting: Position Is of Influence in Men with Prostate Enlargement. A Systematic Review and Meta-Analysis.|journal=PLOS ONE|date=2014|volume=9|issue=7|pages=e101320|DOI=10.1371/journal.pone.0101320|pmid=25051345|pmc=4106761}} External links
2 : Urine tests|Urologic procedures |
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