[Combined urodynamic insufficiency in patients with an infravesical obstruction]

Functional activity of the lower and upper urinary tract was examined in 169 patients with infravesical obstruction and in 20 controls. Combined investigation included: radioisotope uroflowmetry, retrograde cystomanometry, urethrosphincterometry, miction videocystourethrography, excretory urography, radioisotope renography, pharmacorenography, dynamic nephroscintigraphy and renal angiography. An analysis of lower urinary urodynamic findings has demonstrated stages as an important regularity in the development of functional lower urinary disturbances. As a result, a standard system has been evolved for the assessment and classification of stages in chronic lower-urinary urodynamic disorders. Four stages are identified in the classification. Evaluation of upper-urinary urodynamics in the same 169 patients with lower urinary tract disorders of varying severity demonstrated that upper urinary functional parameters become worse as lower urinary parameters deteriorate, but there is no strict correlation between those. A systematic study of the pattern of combined disorders of the lower and upper urinary tract has made it possible to develop a standard system for the assessment and classification of stages of combined urodynamic insufficiency, with 4 stages identified. The use of this system improves objective assessment of the severity of patient's condition and specifies indications for surgical treatment of infravesical obstructions.