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Bladder Filling and Storage: “(Involuntary) Contractions”

  • Chong ChoeEmail author
  • Kathleen C. Kobashi
Chapter

Abstract

Urodynamics (UDS) is the dynamic study of the storage and evacuation of urine. Its role is to provide the clinician with information about a patient’s lower urinary tract function. Ideally, the patient’s symptoms are reproduced during the study to provide objective measurements which correlate with the patient’s symptoms. UDS should be considered as an adjunct to a detailed history and physical exam to better characterize the clinical picture and facilitate optimal treatment planning. An important portion of the UDS is the bladder filling and storage phase. Involuntary detrusor contractions (IDCs) may occur during this portion of the study and may provide insight into the pathophysiology of the patient’s complaints. This chapter will focus on the different UDS manifestations of IDCs by investigating the UDS tracings of neurogenic and idiopathic detrusor overactivity, stress-induced overactivity, phasic overactivity, detrusor overactivity incontinence, detrusor after-contractions, and terminal detrusor overactivity.

Keywords

Detrusor Overactivity Detrusor Contraction Detrusor Pressure Mixed Urinary Incontinence Neurogenic Detrusor Overactivity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Haylen BT, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.PubMedGoogle Scholar
  2. 2.
    Chaliha C, Khullar V. Mixed incontinence. Urology. 2004;63(3 Suppl 1):51–7.PubMedCrossRefGoogle Scholar
  3. 3.
    McGuire EJ, et al. Prognostic value of urodynamic testing in myelodysplastic patients. J Urol. 1981;126(2):205–9.PubMedGoogle Scholar
  4. 4.
    Buckner SA, et al. Spontaneous phasic activity of the pig urinary bladder smooth muscle: characteristics and sensitivity to potassium channel modulators. Br J Pharmacol. 2002;135(3):639–48.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Abrams P, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167–78.PubMedCrossRefGoogle Scholar
  6. 6.
    Hindmarsh JR, Gosling PT, Deane AM. Bladder instability. Is the primary defect in the urethra? Br J Urol. 1983;55(6):648–51.PubMedCrossRefGoogle Scholar
  7. 7.
    Ostergard DR. The neurological control of micturition and integral voiding reflexes. Obstet Gynecol Surv. 1979;34(6):417–23.PubMedCrossRefGoogle Scholar
  8. 8.
    Jung SY, et al. Urethral afferent nerve activity affects the micturition reflex; implication for the relationship between stress incontinence and detrusor instability. J Urol. 1999;162(1):204–12.PubMedCrossRefGoogle Scholar
  9. 9.
    Bump RC, et al. Mixed urinary incontinence symptoms: urodynamic findings, incontinence severity, and treatment response. Obstet Gynecol. 2003;102(1):76–83.PubMedCrossRefGoogle Scholar
  10. 10.
    Webster GD, Kreder KJ. Voiding dysfunction following cystourethropexy: its evaluation and management. J Urol. 1990;144(3):670–3.PubMedGoogle Scholar
  11. 11.
    Smith AL, et al. Detrusor overactivity leak point pressure in women with urgency incontinence. Int Urogynecol J. 2012;23(4):443–6.PubMedCrossRefGoogle Scholar
  12. 12.
    Valentini FA, et al. Phasic or terminal detrusor overactivity in women: age, urodynamic findings and sphincter behavior relationships. Int Braz J Urol. 2011;37(6):773–80.PubMedCrossRefGoogle Scholar
  13. 13.
    Guralnick ML, et al. Objective differences between overactive bladder patients with and without urodynamically proven detrusor overactivity. Int Urogynecol J. 2010;21(3):325–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Kessler TM, Madersbacher H. [Urodynamic phenomena in the aging bladder]. Urologe A. 2004;43(5):542–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Geirsson G, Fall M, Lindstrom S. Subtypes of overactive bladder in old age. Age Ageing. 1993;22(2):125–31.PubMedCrossRefGoogle Scholar
  16. 16.
    Pesce F, Rubilotta E. Detrusor after-contraction: is this important? Curr Urol Rep. 2004;5(5):353–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Hoebeke PB, et al. The after-contraction in paediatric urodynamics. Br J Urol. 1996;78(5):780–2.PubMedCrossRefGoogle Scholar
  18. 18.
    Vereecken RL. The after-contraction: a true detrusor contraction or a late dyssynergic urethral sphincter contraction? BJU Int. 2000;85(3):246–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Beattie J. The neurology of micturition. Can Med Assoc J. 1930;23(1):71–5.PubMedCentralPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Division of Urology and Renal Transplantation, Department of UrologyVirginia Mason Medical CenterSeattleUSA

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