URODYNAMIC TESTS – UROFLOWMETRY, CYSTOMETROGRAPHY, URINARY PRESSURE FLOW, ELECTROMYOGRAPHY, VIDEOFLUROURODYNAMIC STUDY and URETHRAL PRESSURE PROFILE
URODYNAMIC TESTS – UROFLOWMETRY, CYSTOMETROGRAPHY, URINARY PRESSURE FLOW, ELECTROMYOGRAPHY, VIDEOFLUROURODYNAMIC STUDY and URETHRAL PRESSURE PROFILE
1. UROFLOWMETRY
Uroflowmetry is a test that measures the volume of urine released from the body, the speed with which it is released, and how long the release takes.
Procedure: Patient will urinate in a special urinal or toilet with a machine that has a measuring device. He will be asked to begin urinating after the machine has started. When finish, the machine will create a report for health care provider.
This test is useful in evaluating the function of the urinary tract. Usually, a patient having this test will report urination that is too slow.
Health care provider may ask patient to temporarily stop taking medications that can affect the test results. Uroflowmetry is best done when patient have a full bladder. Instruct the patient to do not urinate for 2 hours before the test. Drink extra fluids so he will have plenty of urine for the test. Do not place any toilet tissue in the test machine.
Normal Results: Normal values vary depending on age and sex. In men, urine flow declines with age. Women have less change with age.
Ages 4-7: the average flow rate for both males and female is 10ml/sec.
Ages 8-13: the average flow rate for males is 12ml/sec
The average flow rate for females is 15ml/sec
Ages 14-45: the average flow rate for males is 21ml/sec
The average flow rate for females is 18ml/sec
Ages 46-65: the average flow rate for males is 12ml/sec
The average flow rate for females is 18 ml/sec
Ages 66-80: the average flow rate for males is 9ml/sec
The average flow rate for females is 18ml/sec
2. CYSTOMETROGRAPHY
A cystometrography (CMG) is a graphic recording of the pressures in the bladder. It is the major diagnostic portion of urodynamic testing and is divided into two portions: filling and emptying of the urinary bladder. During the procedure, amount of fluid instilled into the bladder, the patient’s sensation of bladder fullness and urge to void, the degree of staining or hesitancy and amount, size and force of the urinary stream are recorded. These are then compared with the pressure measured in bladder. The residual volume is measured, and catheter is left in place. The uretheral catheter is connected to a water manometer, and sterile solution is allowed to flow into bladder.
3. URINARY PRESSURE FLOW
This is a one of the standard urodynamic test, is performed immediately after the filling phase of the CMG and simultaneously with the voiding CMG, bladder pressure, urine flow, and sphincter electromyography are measured simultaneously. This allows for a detailed picture of the voiding dysfunction.
4. ELECTROMYOGRAPHY
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.
Procedure: the health care provider will insert a very thin needle electrode through the skin into the muscle. The electrode on the needle picks up the electrical activity given off by your muscles. This activity appears on a nearby monitor, and may be heard through a speaker.
After placement of the electrodes, patient may be asked to contract the muscle. For example, bending arm. The electrical activity seen on the monitor provides information about muscle’s ability to respond when the nerves to muscles are stimulated. A nerve conduction velocity test is usually performed along with an EMG.
No special preparation is usually necessary. Avoid using any creams or lotions on the day of the test. Body temperature can affect the results of this test. If it is extremely cold outside, wait in a warm room for a while before the test is performed.
TEST IS PERFORMED:
EMG is most often used when people have symptoms of weakness, and examination shows impaired muscle strength. It can help to tell the difference between muscle weakness caused by injury of a nerve attached to a muscle and weakness due to neurologic disorders.
NORMAL RESULTS:
There is normally very little electrical activity in a muscle while at rest. Inserting the needles can cause some electrical activity, but once the muscles quiet down, there should be little electrical activity detected.
When patient flex a muscle, activity begins to appear. As patient contract muscle more, the electrical activity increases and a pattern can be seen. This pattern helps doctor determine if the muscle is responding as it should.
5. VIDEOFLUROURODYNAMIC STUDY
This is considered as an optimal urodynamic evaluation. This test combines a study of the filling and voiding phase of the CMG and the electromyogram with a simultaneous visualization of the lower urinary tract, allowing for a complete and detailed assessment of the voiding dysfunction.
6. URETHRAL PRESSURE PROFILE
The Urethral pressure profile measures the amount of uretheral pressure along the length of the urethra needed to maintain continence. Gas and fluid are instilled through a catheter that is withdrawn while the pressures along the uretheral wall are obtained.