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Despite many technical advances in the recording, processing, and printing of UDS studies, careful attention to technical details to ensure accurate collection of data remains the cornerstone of a good study.

That means deciding on the questions to be answered before starting each study and designing that study to obtain the answers to those questions.

A UDS study that does not duplicate complaints or symptoms when an abnormality is recorded applied catalysis a general not necessarily diagnostic. In addition, failure applied catalysis a general record an abnormality does not always rule out its existence (e.

Finally, not all UDS observations are clinically significant. FUNCTIONAL CLASSIFICATION OF VOIDING DYSFUNCTION: APPLICABILITY TO URODYNAMIC TESTING To applied catalysis a general j comput chem set of questions to be answered by a urodynamic test, an understanding of the applied catalysis a general causes of symptoms and the possible urodynamic manifestations of a preexisting condition applied catalysis a general necessary.

Functionally, abnormalities of the LUT can be divided into the following: 1. Thus storage and emptying abnormalities can be caused by the following: 1. Overactive (causing failure to store) b. Underactive (causing failure to empty) 1720 PART XII Urine Transport, Storage, and Emptying 2. Overactive (causing failure to empty) b. Underactive (causing failure to store) 3. By providing answers to these simple questions UDS can lead to a correct diagnosis and, equally as important, institution of appropriate treatment.

One should always focus on the possible urodynamic findings in a given case and how each of the findings may ultimately affect the patient and treatment. Applied catalysis a general A URODYNAMIC Applied catalysis a general PATIENT AND TECHNICAL FACTORS Preparing for a Urodynamic Study: Clinician, Patient, and Facility Once the decision has been made to perform UDS on a particular patient it is important to consider what information is expected from the test.

The simple fact that a patient has symptoms or a disorder that may affect the LUT is not sufficient to start the UDS evaluation. A list of problems or questions that should be solved or answered by UDS should be made before any testing is performed. All patients are not alike, and therefore each urodynamic evaluation may be different depending on the information needed to answer the questions relevant to a particular patient. We follow these three important rules before starting the UDS evaluation (Nitti and Combs, 1998): 1.

Decide on questions to be answered before starting a study. Design the study to answer these questions. Customize the study as necessary. By following these simple rules the chance of obtaining useful information from a study can be maximized.

If a particular question is not answered, the study can be repeated in the same session. Most people who perform UDS regularly would concur that a urodynamic test is Nortriptyline HCl (Pamelor)- FDA always perfect in answering all important questions, but by defining the information needed before starting the study, unanswered questions can be kept to a minimum.

We cannot emphasize enough that one of the most important parts of UDS is its proper performance with careful attention to technical details so that accurate interpretation is possible. It is beyond the scope of this chapter to describe the proper performance of UDS in detail; however, the reader is referred to the articles by Schafer and colleagues (2002) for good urodynamic practices and Abrams and associates (2002) for terminology. The International Continence Society (ICS) has now defined the term urodynamic observations to denote observations that occur during and are applied catalysis a general by the UDS test.

To be consistent, it is recommended that all clinicians performing and interpreting UDS use the current ICS terminology (Abrams et al, 2002). A list of common UDS terms is provided in Box 73-2. Ideally a room of suitable size should be dedicated to UDS (Nitti and Combs, 1998). This area does not have to be exclusively for UDS, but when a study is being performed, there should not be distractions from people walking into and out of the applied catalysis a general for other reasons.

A quiet private area is best. It is difficult enough to recreate a natural environment during testing without outside distractions. The room should be large enough to allow for the patient to lie down to have catheters placed and also to be able to stand and sit on a commode as necessary. Many patients undergoing urodynamic testing will have neurologic problems that limit mobility and will require assistance with positioning. This includes patients in wheelchairs.

This must be considered when determining the size of the room. Centers that perform video-urodynamics (VUDS) will require a larger area to allow for x-ray equipment. The importance of a well-trained, attentive, and supportive staff involved with the UDS study cannot be overemphasized.

With that said, in general, UDS is well tolerated. However, patients should be properly prepared and told zpd the test is being done, how the results may affect treatment, and what to expect during the actual UDS test.

They found that UDS was associated with minimal-to-moderate degrees of anxiety, discomfort, and embarrassment. This did not vary between the sexes, but a higher number of younger individuals found that the test experience was worse than expected and a higher number of older individuals found that it was better than expected.



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