urodynamiques

Urodynamics is a set of diagnostic procedures used to evaluate the function of the lower urinary tract, including the bladder, detrusor muscle, and urethral outlet. The tests assess storage (filling) and voiding phases to explain symptoms such as urgency, frequency, incontinence, and hesitancy. Core components include cystometry, uroflowmetry, and pressure-flow studies, with optional additions such as electromyography.

Key measurements are bladder capacity and compliance during filling, detrusor pressure, peak flow rate, and post-void residual urine. Uroflowmetry is noninvasive and measures urine flow and volume. Invasive tests fill the bladder with sterile fluid while recording bladder and abdominal pressures, and sometimes urethral sphincter activity. These data yield pressure-flow relationships that help distinguish detrusor overactivity or underactivity from bladder outlet obstruction.

Indications include evaluation of lower urinary tract symptoms, detrusor overactivity, neurogenic bladder, and urinary incontinence, as well as preoperative assessment before certain surgeries or therapies. Results guide treatment choices, such as antimuscarinic or beta-3 agonist medications for overactivity, alpha-blockers for obstruction, neuromodulation, bladder rehabilitation, or surgical interventions.

Limitations include invasiveness, patient discomfort, and risk of urinary tract infection. Interpretation requires expertise and may vary with technique and patient factors. Urodynamics is most informative when integrated with history, imaging, and other tests.