VIDEOURODYNAMIC STUDIES

VIDEOURODYNAMIC EQUIPMENT

The typical videourodynamic equipment components and connections are shown in Figure 1.

INDICATIONS

A videourodynamic evaluation is indicated when the diagnosis cannot be made with certainty using standard diagnostic or urodynamic methods. The situations in which videourodynamics are particularly helpful are listed in Table 1. The most common indication is the evaluation of incontinence in females because a videourodynamic study does what cannot be done by physical examination, cystometrograms (CMG), and urethral pressure profiles: reliably establish a definitive cause for the incontinence.

In

VIDEOURODYNAMIC TESTING IN FEMALES

Videourodynamic studies are particularly useful in the diagnosis of the cause of urinary incontinence in females. Leakage can occur at a low ALPP owing to poor function of the urethra, at a high ALPP owing to loss of urethral support with urethral hypermobility, or owing to a combination of urethral mobility and urethral dysfunction.⁷ It is important to know the exact cause because the treatment is different in each case. In other words, the use of a standard bladder neck suspension procedure

VIDEOURODYNAMIC TESTING IN MALES

There are really only two reasons for stress incontinence in males: (1) intrinsic sphincter deficiency (without urethral mobility); and (2) poor bladder compliance. Both conditions are reliably diagnosed by a videourodynamic study. A 10-Fr triple lumen catheter is placed into the bladder and the proximal port is pulled to the external sphincter. The bladder is filled to capacity to evaluate sensation, detrusor compliance, or detrusor instability or for a voiding study. If the cause of