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Related Experiment Videos

Abnormal detrusor function precipitating hydronephrosis identified by extended voiding cystometry

L A Kerr1, S B Bauer, D R Staskin

  • 1Department of Urology, George Washington University Medical Center, Washington, D.C. 20037.

The Journal of Urology
|July 1, 1994
PubMed
Summary
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Extended voiding cystometry revealed true detrusor dysfunction missed by standard methods. This advanced technique identified high inter-contraction pressure and abnormal contractions, preventing misdiagnosis of bladder issues.

Area of Science:

  • Urology
  • Urodynamics
  • Lower Urinary Tract Symptoms

Background:

  • Standard fill cystometry can misdiagnose detrusor function due to artifacts like instability and noncompliance.
  • Accurate assessment of detrusor muscle activity is crucial for diagnosing bladder dysfunction.
  • Extended voiding cystometry offers a more comprehensive evaluation of bladder behavior.

Observation:

  • A patient initially misdiagnosed by standard fill cystometry underwent extended voiding cystometry.
  • This method allowed for prolonged observation of bladder activity, mitigating artifacts.
  • Chronic elevation of intravesical pressure between contractions (inter-contraction pressure) was noted.

Findings:

  • The study documented frequent, high-amplitude, long-duration detrusor contractions during the bladder's storage phase.

Related Experiment Videos

  • A significant post-void residual urine volume was observed.
  • These urodynamic abnormalities indicate true detrusor dysfunction.

    • Implications:

    • Extended voiding cystometry accurately elucidates detrusor function, avoiding misdiagnosis.
    • The identified urodynamic abnormalities can lead to hydroureteronephrosis even without vesicoureteral reflux.
    • This highlights the importance of advanced urodynamic assessment in complex bladder cases.