TEALE FENNING

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 973

Filling Cystometry -- ICS defn.

The urethral closure mechanism during storage may be competent or incompetent.

Normal urethral closure mechanism maintains a positive urethral closure pressure during bladder filling even in the presence of increased abdominal pressure, although it may be overcome by detrusor overactivity.

Incompetent urethral closure mechanism is defined as one which allows leakage of urine in the absence of a detrusor contraction.

Urethral relaxation incontinence is defined as leakage due to urethral relaxation in the absence of raised abdominal pressure or detrusor overactivity.

Urodynamic stress incontinence is noted during filling cystometry and is defined as the involuntary leakage of urine during increased abdominal pressure, in the absence of a detrusor contraction.

Urethral pressure is defined as the fluid pressure needed to just open a closed urethra.

Urethral pressure profile is a graph indicating the intraluminal pressure along the length of the urethra. It is given by the subtraction of intravesical pressure from urethral pressure.

Maximum urethral pressure is the maximum pressure of the measured profile.

Maximum urethral closure pressure (MUCP) is the maximum difference between the urethral pressure and the intravesical pressure.

Functional profile length is the length of the urethra along which the urethral pressure exceeds intravesical pressure in women.

Pressure “transmission” ratio is the increment in urethral pressure on stress as a percentage of the simultaneously recorded increment in intravesical pressure.

Abnormal leak point pressure is the intravesical pressure at which urine leakage occurs due to increased abdominal pressure in the absence of a detrusor contraction.

[The Leak Pressure Point should be qualified according to the site of pressure measurement (rectal, vaginal or intravesical) and the method by which pressure is generated (cough or valsalva).
Leak point pressures may be calculated in three ways from the three different baseline values which are in common use: zero (the true zero of intravesical pressure), the value of pves measured at zero bladder volume, or the value of pves immediately before the cough or valsalva (usually at 200 or 300ml bladder capacity).
The baseline used, and the baseline pressure, should be specified.]

Detrusor leak point pressure is defined as the lowest detrusor pressure at which urine leakage occurs in the absence of either a detrusor contraction or increased abdominal pressure.
_________________
Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region

rpwalavalkar · Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 973

detrusor in VOIDING STUDIES

acontractile one that cannot be demonstrated to contract during urodynamics

areflexic a contractility due to an abnormality of nervous control

underactive a detrusor contraction of inadequate magnitude and/or duration to effect bladder emptying

normal voluntarily initiated contraction that is sustained and can usually be suppressed voluntarily
_________________
Dr Miss. Raj Walavalkar MBBS MRCOG
TealeFenning Administrator
SR O&G Wessex Region