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Urodynamics

Urodynamics is the study of the functional and physiological aspects of the urinary tract system.
It involves the assessment of bladder, sphincter, and urethra function through the use of various diagnostic tests and measurements.
Urodynamic studies provide valuable information about the storage and emptying phases of the urinary cycle, helping clinicians diagnose and manage conditions such as incontinence, neurogenic bladder, and voiding dysfunction.
By understanding the underlying urodynamic mechanisms, healthcare providers can develop personalized treatment plans to improve patient outcomes and quality of life.
Explore the latest advancements in urodynamics research through PubComare.ai's AI-driven platform, which helps users optimize their studies by identifying the best protocols from literature, pre-prints, and patents.
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Most cited protocols related to «Urodynamics»

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Publication 2011
Diagnosis Lower Urinary Tract Symptoms Patients Pelvic Pain Sterility, Reproductive Urethra Urinary Bladder Urine Urodynamics Woman
This was a multicenter, randomized equivalence trial comparing the retropubic midurethral sling with the transobturator midurethral sling for the treatment of stress incontinence. The study methods have been described previously.14 Women 21 years of age or older who were planning to undergo surgery for the treatment of stress incontinence were invited to participate. Eligibility requirements included at least a 3-month history of symptoms of urinary incontinence that were predominantly or solely associated with stress incontinence (as compared with urge incontinence) and a positive urinary stress test at a bladder volume of 300 ml or less (urodynamic stress leakage was not required). Randomization was performed after anesthesia was administered. Women were randomly assigned with the use of a permuted-block randomization schedule, with stratification according to clinical site. After the surgery, information regarding the treatment assignment was not kept from the patient. An institutional review board at each of the nine clinical sites and the coordinating center approved the study protocol. Written informed consent was obtained from all participants. An independent data and safety monitoring board reviewed the progress, interim results, and safety of the study.
Publication 2010
A 300 Anesthesia Clinical Trials Data Monitoring Committees Eligibility Determination Ethics Committees, Research Exercise Tests Operative Surgical Procedures Patients Safety Urinary Bladder Urinary Incontinence Urinary Stress Incontinence Urodynamics Woman
After obtaining study approval from the University of Utah Health Sciences Center Institutional Review Board, informed consent was collected from seven volunteers undergoing standard urodynamic testing. A sterile wireless Gen2 IVT and standard rectal balloon catheter was placed in each study participant by a member of the clinical research team. Each participant performed a series of coughs followed by a Valsalva maneuver both in the seated and standing position. Rectal balloon IAP readings were recorded at 15 Hz using clinical cystometry software (Laborie Medical Technologies) under a standard bladder volume of 200 ml. Wireless IVT pressure measurements were taken at 30 Hz using the Zarlink ADK base station and custom laptop software. Results of each transducer were plotted and compared.
Publication 2011
Catheters Cough Ethics Committees, Research Pressure Rectum Sterility, Reproductive Transducers Urinary Bladder Urodynamics Valsalva Maneuver Voluntary Workers
The Value of Urodynamic Evaluation (VALUE) study, an 11-center, randomized, noninferiority trial, compared the results among women who underwent an office evaluation without urodynamic testing (evaluation-only group) with those among women who underwent urodynamic testing in addition to the office evaluation (urodynamic-testing group) before their planned surgery. Details of the study design and methods have been published previously,9 (link) and the protocol is available with the full text of this article at NEJM.org.
Women presenting with urinary incontinence underwent a standardized basic office evaluation and were eligible for the study if they were 21 years of age or older, had a history of symptoms of stress urinary incontinence for at least 3 months, and had a score on the Medical, Epidemiological, and Social Aspects of Aging (MESA) questionnaire for stress urinary incontinence that was greater than the score on this questionnaire for urgency incontinence,10 (link) a postvoiding residual urine volume of less than 150 ml, a negative urinalysis or urine culture, a clinical assessment of urethral mobility, a desire for surgery for stress urinary incontinence, and a positive provocative stress test (defined as an observed transurethral loss of urine that was simultaneous with a cough or Valsalva maneuver at any bladder volume). Exclusion criteria were previous surgery for incontinence, a history of pelvic irradiation, pelvic surgery within the previous 3 months, and anterior or apical pelvic-organ prolapse of 1 cm or more distal to the hymen. Eligible patients were invited to participate in the study and asked to provide consent before any urodynamic testing was performed. After written informed consent had been obtained, study surgeons recorded their diagnoses on a comprehensive checklist of clinical diagnoses.
Patients were randomly assigned to a study group with the use of an automated randomization system stratified according to surgeon; more than 90% of the surgeons were fellowship-trained. Women in the urodynamic-testing group underwent noninstrumented uroflowmetry with a comfortably full bladder, filling cystometry with Valsalva leak-point pressures, and a pressure-flow study. Urethral pressure profilometry or urodynamic testing with the use of video was permitted if it was routinely performed as part of the pre-operative investigation at the study site. Testing followed the Good Urodynamic Practice guidelines of the International Continence Society,11 (link) and interpretation conformed to International Continence Society nomenclature.12 (link) After interpretation of the urodynamic tests, study physicians again completed the same comprehensive checklist of clinical diagnoses without viewing their previous entries. At office visits 3 and 12 months after treatment, outcome data were obtained by study personnel who were unaware of the group assignments.
The protocol was approved by the institutional review board at each site, and an independent data and safety monitoring board reviewed the progress and safety of the study. The third author, the senior statistician for the study, vouches for the accuracy of the reported data and for the fidelity of the study to the protocol.
Publication 2012
Aftercare Clinical Trials Data Monitoring Committees Cough Diagnosis Ethics Committees, Research Exercise Tests Fellowships Hymen Office Visits Operative Surgical Procedures Patients Pelvic Organ Prolapse Pelvis Physicians Pressure Radiotherapy Range of Motion, Articular Safety Surgeons Urethra Urinalysis Urinary Bladder Urinary Incontinence Urinary Stress Incontinence Urine Urodynamics Valsalva Maneuver Volume, Residual Woman
The composite primary outcome was assessed at 12 months after randomization and included treatment success according to objective criteria and treatment success according to subjective criteria. The objective criteria were a negative provocative stress test, a negative 24-hour pad test, and no retreatment (behavioral, pharmacologic, or surgical) for stress incontinence; the subjective criteria were the absence of self-reported symptoms of stress-type urinary incontinence, as assessed with the use of the Medical, Epidemiological and Social Aspects of Aging (MESA)16 (link) questionnaire, no leakage recorded in a 3-day voiding diary, and no retreatment for stress incontinence. A woman could not be classified as having met the criteria for the primary outcome if she had had a documented treatment failure. Data were collected before surgery and 2 weeks, 6 weeks, and 6 and 12 months after surgery by means of interviews and clinical examinations. The urodynamic measures that were assessed are listed in Table 1. Patient satisfaction was assessed at 12 months with the question, “How satisfied or dissatisfied are you with the result of bladder surgery related to urine leakage?” Possible responses were completely satisfied, mostly satisfied, neutral, mostly dissatisfied, and completely dissatisfied. Completely and mostly satisfied were reported as “satisfied,” and neutral, mostly dissatisfied, and completely dissatisfied as “not satisfied.” The reporting of adverse events and the classification of the severity of events were standardized across sites with the use of specific pre-specified definitions of events and a modified version of the classification system of Dindo et al.17 (link)
Publication 2010
Exercise Tests Operative Surgical Procedures Physical Examination Retreatments Urinary Bladder Urinary Stress Incontinence Urine Urodynamics Woman

Most recents protocols related to «Urodynamics»

This study was conducted using retrospective clinical data from VGHTC database, and was approved by institutional review board with No. CE21221A. The study endpoints included the usage of adrenergic alpha-blockers and antispasmodics after surgery for at least three months. Most patients returned back to the outpatient clinic one week after discharge and were followed up every three months afterward. The cut-off of minimum three months was identical to previous study, and was determined based on the fact that some patients may require short-term medications for LUTS [6 (link)]. The adrenergic alpha-blockers and antispasmodics prescribed within a month postoperatively were neglected since these medicines prescribed then may be for operation-related symptom relief. Data collected were classified into preoperative data and perioperative data. Preoperative data included age, body mass index (BMI), prostate specific antigen (PSA), comorbidities (hypertension, ICD9 401–405, ICD10 I10-I16; diabetes mellitus [DM], ICD9 250, ICD 10 E08-E13; ischemic heart disease, ICD9 410–414, ICD10 I20-I25; cerebrovascular disease, ICD9 430–438, ICD I60-I69; hyperlipidemia, ICD9 272, ICD10 E78; chronic obstructive pulmonary disease [COPD], ICD9 490–496, ICD10 J40-J47; peripheral vascular disease, ICD9 440–449, ICD10 I70-I79; chronic kidney disease [CKD], ICD9 585, ICD10 N18; sleep disorder, ICD9 327, ICD10 G47; gout ICD9 274, ICD10, M10), history of prostate surgery, urodynamic testing results, and the usage of adrenergic alpha-blockers, 5-alpha reductase inhibitors (5-ARIs), and antispasmodics before surgery. The age and BMI data was collected at time of operation. PSA level was collected within a year before surgery. Urodynamic testing included maximum flow rate, average flow rate, voided volume and post-void residual volume, and was performed within a year preoperatively. The adrenergic alpha-blockers, 5-ARIs and antispasmodics were coded using anatomical therapeutic chemical classification. The adrenergic alpha-blockers and 5-ARIs included Doxazosin 2mg and 4mg (C02CA04), Alfuzosin 10mg (G04CA01), Tamsulosin 0.2mg and 0.4mg (G04CA02), Terazosin 1mg and 2mg (G04CA03), Silodosin 4mg (G04CA04), Tamsulosin plus Dutasteride 0.4mg/0.5mg (G04CA52), Dutasteride 0.5mg (G04CB02), Finasteride 5mg (G04CB01). The antispasmodics included Oxybutynin 5mg (G04BD04), Tolterodine 2mg and 4mg (G04BD07), Solifenacin 5mg (G04BD08), Trospium 10mg (G04BD09), and Mirabegron 25mg and 50mg (G04BD12). Usage of adrenergic alpha-blockers, 5-ARIs and antispasmodics preoperatively were only adopted if the usage duration last at least three months.
On the contrary, perioperative data included surgical methods and resected prostate volume to preoperative prostate volume ratios. Surgical methods contained TURP, which included monopolar TURP and bipolar TURP, and laser procedure, which included laser enucleation of prostate and photoselective vaporization. Resected prostate weight to preoperative prostate volume ratios were calculated using resected prostate weight, which was based on final histopathology weight, and preoperative prostate volume, which was measured by trans-abdominal ultrasound performed within a year before surgery.
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Publication 2023
5-alpha Reductase Inhibitors Abdomen Adrenergic alpha-Antagonists alfuzosin Antispasmodics Cerebrovascular Disorders Chronic Kidney Diseases Chronic Obstructive Airway Disease Diabetes Mellitus Doxazosin Dutasteride Ethics Committees, Research Finasteride Gout High Blood Pressures Hyperlipidemia Index, Body Mass Lutein mirabegron Myocardial Ischemia Operative Surgical Procedures oxybutynin Patient Discharge Patients Peripheral Vascular Diseases Pharmaceutical Preparations Prostate Prostate-Specific Antigen silodosin Sleep Disorders Solifenacin Tamsulosin Terazosin Therapeutics Tolterodine Transurethral Resection of Prostate Ultrasonography Urination Urodynamics Vaporization Volume, Residual
A total of 165 patients with VUR from PUV and following reconstruction of exstrophy bladder were treated at our center from March 2005 to April 2019. Out of 165 patients, 135 patients (170 renal units; n = 146 from PUV and n = 24 from exstrophy bladder) had adequate data regarding control/correction of obstruction and urodynamic studies, etc. The mean patient's age was 2.8 years (range 1 day–14 years).
The diagnosis of VUR was made with cystogram following fulguration in PUV patients and at follow-up in patients with repaired continent bladder exstrophy. We did MCB (Mitra, Chatterjee, Basu) cystograms not MCU following USG showing dilated ureter/s as mentioned by some authors.[5 (link)] In MCB cystogram, as mentioned, we introduced contrast in the bladder. Absence of VUR following MCB cystogram indicates uretero vesical junction obstruction (UVJO). On the other hand, following the presence of VUR, we released catheter to empty the contrast from bladder and ureters. We labeled VUR as “rise and fall” VUR (raf_VUR) if we had found no residual in ureter/s after 30 min [Flow chart 1]. That was an “innocent VUR” i.e., without obstruction [Figure 2]. In another group, we had found stasis of post-void residual in ureter/s for more than 30–180 or more minutes. We labeled those VUR as “rise and stasis” VUR (ras_VUR); which means combination of VUR with UVJO. Combination VUR with UVJO confirmed post void residual of contrast in ureters persisting [Figure 3] following MCB and their progression or regression was monitored with the diameter of calyx, ureters, and cortical thickness by USG Renometry (USGR) during follow-up as mentioned by some authors.[5 (link)] All 19 patients with exstrophy bladder were continent, either with CIC or natural Void or with both. However, had VUR in 24 renal units. Superficial bladder neck incision (BNI) was done in two continent patients with repaired exstrophy.
All patients were followed up with albumin creatinine ratio (ACR), CCr to monitor USCKD, USGR, DTPA renal scan, and uroflowmetry. All patients were advised for UDS, particularly for Pdet, Pdet Qmax, and DLPP to exclude or confirm increased bladder pressure from outlet obstruction. Repeat cystoscopy, if necessary, was done following UDS for secondary BNI or to repeat BNI if necessary. Following BNI in patients with suspected UVJO were kept on anticholinergics for few months and monitored with USGR, ACR and CCr. We did DJ stenting [Figure 4] or re-implantations if the deterioration of renal function was found to be >10% from the previous level even with anticholinergics. During the reimplantation of ureters, caliber of ureters was thicker due to muscular hypertrophy. Hence, those ureters were not tapered, unlike the thinner wall of ureter with raf_VUR and minimal tunnels through thicker bladder wall were created to avoid re-obstruction.
Publication 2023
Albumins Anticholinergic Agents Bladder Exstrophy Bladder Neck Obstruction Catheters Creatinine Cystography Cystoscopy Diagnosis Disease Progression Electrocoagulation Hypertrophy Kidney Kidney Calices Kidney Cortex Muscle Tissue Neck Patients Pentetic Acid Pressure Radionuclide Imaging Reconstructive Surgical Procedures Surgical Replantation Ureter Urinary Bladder Urination Urodynamics
The Research and Ethics Committee of Al-Ain Medical District in UAE (CRD 82/10, 12/01/2012) gave approval for this study after ensuring that all necessary ethics and consent standards were met. All women with antenatal incontinence gave written informed consent to participate in the follow-up after delivery. Our study was reported according to the criteria of the STROBE checklist.[10 (link)]This was a prospective cohort study completing the follow-up of all nulliparous women recruited antenatally from 2012 to 2014 in Al-Ain Hospital, Al-Ain, UAE, reported in a previously published paper.[11 (link)] The current study included all consecutive nulliparous women with urinary incontinence for the first time during pregnancy presenting to the hospital for childbirth and who were followed up for 3 months after discharge.
The questionnaire design was described in detail previously.[11 (link)] To overcome the language barrier, both English and Arabic questionnaires were prepared. The questionnaires contained separate sections on sociodemographic history, medical history, and the characteristics of pregnancy, childbirth and 3 months postpartum. The questionnaire was piloted and revised accordingly. Special training was given to the interviewers about the questionnaire and the techniques of interviewing. We made sure that its items were simple and easy to answer by testing them in a pilot study on volunteers, which was conducted by our healthcare team. Our publications using this questionnaire demonstrates its usefulness.[12 (link)–14 ] We did not perform urodynamic studies and depended on the responses of the questionnaire to define the nature of the incontinence. Basic characteristics captured in the questionnaire were age, occupation, education level, and smoking history. Characteristics during pregnancy were urinary tract infection, diabetes, chronic chest problems (cough), chronic constipation, and smoking. Data about pelvic floor muscles exercise and consultation by a physiotherapist during the pregnancy, labor type, duration of labor, and mode of delivery were collected. Post-delivery characteristics included urinary tract infection after the delivery and the child’s birth weight.
The patients who were nulliparous pregnant women with urinary incontinence during pregnancy were divided into 2 groups depending on the postpartum urinary incontinence status at 3 months. The 2 groups were compared using Fisher exact test for categorical data and Mann–Whitney U test for continuous data with a significance threshold P < .05. Data were analyzed using the Statistical Package for Social Sciences (IBM-SPSS version 26, Chicago, IL).
Publication 2023
Birth Weight Chest Child Childbirth Constipation Cough Diabetes Mellitus Ethics Committees Interviewers Medical Care Team Muscle Tissue Obstetric Delivery Obstetric Labor Patient Discharge Patients Pelvic Diaphragm Physical Therapist Pregnancy Pregnant Women Urinary Incontinence Urinary Tract Infection Urodynamics Voluntary Workers Woman
Categorical variables were presented as frequencies (proportions), while continuous variables were expressed as the mean ± standard deviation. Urodynamic parameters at baseline and after treatment were compared using the paired t-test, which was also used to determine differences in symptom scores and objective parameters between groups. On the other hand, the analysis of variance was used to determine differences between subgroups. The Chi-square test was used to analyze categorical variables.
To identify the predictive factors of a good treatment outcome, we used a forward selection method to perform multivariate analyses. Receiver operating characteristic (ROC) curve analyses were performed to identify the optimum cutoff value for predicting better outcomes for DU patients. Accordingly, the optimal cutoff value was indicated by the point on the ROC curve that was closest to the upper left-hand corner. All statistical analyses were performed using SPSS for Windows (Version 16.0; SPSS, Chicago, IL, USA). A p-value of <0.05 was considered statistically significant.
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Publication 2023
Aftercare Patients Prognosis Urodynamics
We retrospectively reviewed women who had voiding dysfunction and underwent TUI-BN at least once at our institution from March 2007 to April 2019. All patients underwent VUDS before TUI-BN and after this operation. Female patients with proven urinary tract infections, previous anti-incontinence surgery, or spinal cord injury were not enrolled in this study. This study had been approved by the Institutional Review Board and the Ethics Committee of Hualien Tzu Chi Hospital, Hualien, Taiwan (IRB: 100-06). Informed consent was waived due to the retrospective nature of the analysis.
VUDS was performed in accordance with the recommendations of the International Continence Society [10 (link)]. A multichannel urodynamic system (Life-Tech Inc., Stafford, TX, USA) and a C-arm fluoroscope (Toshiba, Tokyo, Japan) were used. VUDS was repeated at least twice to obtain a reproducible pressure flow trace. The first sensation of filling (FSF), full sensation (FS), cystometric bladder capacity (CBC), bladder compliance, maximum flow rate (Qmax), detrusor pressure at Qmax (Pdet.Qmax), post-void residual volume (PVR), sphincter electromyography activity (EMG), voided volume (Vol), bladder outlet obstruction index (BOOI, defined as Pdet.Qmax − [2 × Qmax]), bladder contractility index (BCI, defined as BCI = Pdet Qmax + 5 Qmax), voiding efficiency (VE, defined as voided Vol/bladder capacity × 100%), and corrected maximum flow rate (cQmax, defined as Qmax/Vol1/2) were documented. During VUDS, voiding cystourethrography was carried out using a C-arm fluoroscope positioned 45 degrees from the buttocks so that the urethra could be lengthened and the bladder neck, urethral sphincter, and distal urethra could be clearly seen.
Patients with severe difficulty in urination, straining while voiding, large PVR, and a narrow bladder neck observed during voiding in VUDS, were initially treated with alpha-blockers for at least three months. If LUTS were refractory to medication, TUI-BN was advised. The surgical procedure of TUI-BN has been reported in a previous study [8 (link)]. If patients still had dysuria, straining while voiding, large PVR, or VE less than 25% after the initial TUI-BN, post-operative VUDS was performed. Consecutive TUI-BN, transurethral external sphincter incision (TUI-ES), or urethral sphincter onabotulinumtoxin A (Botox) injection was advised according to the findings in the second VUDS. Patients with neurological deficit such as a history of cerebrovascular accident, Parkinsonism, myelomeningocele, poliomyelitis, radical hysterectomy, or spine surgery were categorized as with neurologic bladder. Patients without any neurological deficit were grouped into the with non-neurogenic bladder category. The current voiding status was recorded through direct interviews by the same research assistant. The surgical complications such as de novo incontinence and vesicovaginal fistula and additional surgical procedures for complications such as suburethral sling implantation and urethral platelet-rich plasma (PRP) injection were documented.
The descriptions and terminology for urodynamic parameters were in accordance with the recommendations of the International Continence Society [11 (link)]. The primary endpoint of this study was the success rate between TUI-BN alone and TUI-BN with an additional procedure. We defined an improvement in VE by ≥ 50% after treatment as a successful outcome. The parameters between the successful and failed groups were compared using the chi-square test for categorical variables and the Wilcoxon rank-sum test for continuous variables. The secondary endpoint of this study is the predictor factors for surgical success. The demographics and VUDS parameters were analyzed using univariate and multivariate logistic regression to clarify the predictive factors and the discriminatory capacity was investigated using an area under the curve (AUC) analysis. A p-value < 0.05 was considered statistically significant. Complications of the surgery are the third endpoint for this study.
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Publication 2023
Adrenergic alpha-Antagonists Aftercare Bladder Neck Obstruction Botox Buttocks Cerebrovascular Accident Dysuria Electromyography Ethics Committees, Clinical Fluoroscopy Hysterectomy Lutein Meningomyelocele Muscle Contraction Neck Neurogenic Urinary Bladder OnabotulinumtoxinA Operative Surgical Procedures Ovum Implantation Parkinsonian Disorders Patients Pharmaceutical Preparations Platelet-Rich Plasma Poliomyelitis Pressure Spinal Cord Injuries Systems, Nervous Urethra Urethral Sphincters Urinary Bladder Urinary Tract Infection Urodynamics Vertebral Column Vesicovaginal Fistula Vision Volume, Residual Woman

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More about "Urodynamics"

Urodynamics is the comprehensive study of the functional and physiological aspects of the urinary tract system.
This field encompasses the assessment of bladder, sphincter, and urethra function through various diagnostic tests and measurements.
Urodynamic studies provide invaluable insights into the storage and emptying phases of the urinary cycle, enabling healthcare providers to diagnose and manage conditions such as incontinence, neurogenic bladder, and voiding dysfunction.
By understanding the underlying urodynamic mechanisms, clinicians can develop personalized treatment plans to improve patient outcomes and quality of life.
The latest advancements in urodynamics research, leveraging tools like the Statistical Package for the Social Sciences (SPSS) software, Prism 6 data analysis software, and specialized equipment like the U2500 pressure transducer and Aladdin-1000 infusion pump, have significantly enhanced the reproducibility and accuracy of these studies.
Cutting-edge technologies, such as the Ingenia 3.0T MRI system, have also been integrated into urodynamic assessments, providing healthcare professionals with even more comprehensive insights into the urinary tract system.
Explore the latest innovations in urodynamics research through PubCompare.ai's AI-driven platform, which helps users optimize their studies by identifying the best protocols from literature, pre-prints, and patents.
Leverage AI-powered comparisons to enhance reproducibility nad accuracy, and take your urodynamics research to new heights.