For those patients who have bladder control problems because of spinal cord injury, multiple sclerosis, or other neurological condition, urodynamics is an essential tool to direct management. Urodynamic studies are generally performed by placing a small catheter into the bladder and then filling the bladder with either water or radiopaque contrast. The pressure within the bladder is measured, usually electronically, and the activity of the external urethral sphincter can be measured as well. When these studies are done with Xray capability, the configuration of the bladder can be assessed, as well as any evidence of vesico-ureteral reflux. Finally, during urination, the presence of absence of obstruction can be determined by measurement of the flow rate and voiding pressure.
Urodynamic studies comprise a spectrum from simple and non-invasive to complex and invasive.
Formal urodynamic studies are generally performed by placing a small catheter into the bladder and then filling the bladder with either water or radiopaque contrast. The pressure within the bladder is measured, usually electronically, and the activity of the external urethral sphincter can be measured as well. When these studies are done with Xray capability, the configuration of the bladder can be assessed, as well as any evidence of vesico-ureteral reflux. Finally, during urination, the presence of absence of obstruction can be determined by measurement of the flow rate and voiding pressure. Augmentation Cystoplasty Patients with neurogenic bladders, such as those with spinal cord injury, often cannot hold an adequate volume of urine in their bladders and must use anticholinergic medications to increase capacity.