Mục đích của thử nghiệm urodynamic là để tái sản xuất các triệu chứng của bệnh nhân trong một phòng thí nghiệm kiểm soát. Một loạt các phép đo (áp lực bàng quang và niệu đạo, nước tiểu tốc độ dòng chảy, fluoroscopic hình ảnh) được thực hiện, và dựa trên những quan sát và sự nhạy bén lâm sàng của bác sĩ kiểm t | 4 Urodynamics and the Evaluation of Male Lower Urinary Tract Symptoms J. Quentin Clemens MD MSCI Contents Introduction Uroflowmetry Pressure-Flow Studies V ideourodynamics Cystometry Symptoms and Urodynamic Findings Predictive Value of Urodynamics Indications for Urodynamic Studies in Men with LUTS Conclusion References INTRODUCTION The purpose of urodynamic testing is to reproduce the patient s symptoms in a controlled laboratory setting. A variety of measurements bladder and urethral pressures urine flow rate fluoroscopic imaging are made and based on these observations and the clinical acumen of the examining physician a diagnosis can be found that explains the patient s complaints. in men with lower urinary tract symptoms LuTs the primary urodynamic question is whether or not there is bladder outlet obstruction. A variety of urodynamic techniques may be used to address this question. From Management of Benign Prostatic Hypertrophy Edited by K. T. McVary Humana Press Inc. Totowa NJ 47 48 Clemens Fig. 1. Siroky nomogram for evaluation of uroflow results. The peak flow rate vertical axis and total bladder volume voided volume plus residual volume horizontal axis are plotted as a single point on the nomogram. The shaded zone indicates values that occur in of the normal male population. UROFLOWMETRY Uroflowmetry is an attractive test for both clinician and patient because it is simple to perform and noninvasive. The most clinically useful measurement is the maximum urinary flow rate Qmax which is measured in milliliters per second. Other information that may be obtained includes the flow pattern continuous or intermittent average flow rate shape of the flow curve flow time and time to maximum flow. Postvoid residual bladder volume may also be assessed with ultrasonography after the void. Uroflowmetry may be done with the patient in the standing or supine position to best mimic normal voiding patterns at home. In general Qmax of 10 mL s is considered abnormal .
