Urodynamics

Lower urinary tract dysfunction produces a huge burden on sufferers in particular and on society in general. Lower urinary tract symptoms have a high prevalence in the community: 5% of children aged 10 wet the bed, while 15% of women and 7% of men have troublesome in­ continence; and in elderly men of 75, benign prostatic hyperplasia occurs in more than 80% of individuals, with benign prostatic en­ largement coexisting in up to half this group and half of these having bladder outlet obstruction. The confusion felt in many people's minds as to the role of uro­ dynamics has receded for the most part. The need to support the clinical assessment with objective measurement has become accepted by most clinicians specialising in the care of patients with lower urinary tract symptoms (LUTS). Since the first edition of this book in 1983, urodynamics has become more widely accepted. In the last ten years the number of urodynamic units in Britain and Europe has increased rapidly and almost every hospital of any significance embraces urodynamic investigations as an essential part of the diag­ nostic armamentarium of the urology and gynaecology departments. Further, specialists in geriatrics, paediatrics and neurology recognise the importance of urodynamics in the investigation of a significant minority of their patients. This new edition of Urodynamics takes into account the technological innovations and new techniques that have been introduced since the publication of the first edition in 1983. Urodynamics have since become more widely accepted and most hospitals now recognise that it is an essential part of the diagnostic process in urology and gynaecology. Specialists in geriatrics, paediatrics and neurology also recognise the importance of urodynamics in the investigation of a significant number of their patients. The purpose of the book is to provide a simple yet practical guide to the functional investigation of patients with incontinence and voiding disturbances. The text makes clear the fundamental and vital contribution of urodynamic investigation to the management of patients with any form of lower urinary tract dysfunction. The book concentrates on common clinical problems and the presenting symptom complexes rather than diagnosis; the limitations and possible artefacts of investigation are highlighted. Any clinician without previous experience in urodynamics will be able to appreciate the value and limitations of these investigative techniques as well as obtaining the necessary practical advice on the use of the appropriate equipment in the correct situations. Paul Abrams is Honorary Secretary of the International Continence Society, consultant urologist and Chairman of Research at the Bristol Urological Institute based at Southmead Hospital in Bristol. He is also the author of several books in the field. Front Matter....Pages i-x Principles of Urodynamics....Pages 1-6 Anatomy and Physiology....Pages 7-16 Urodynamic Techniques....Pages 17-117 Patient Assessment....Pages 118-147 Urodynamics in Clinical Practice....Pages 148-172 Management of Lower Urinary Tract Dysfunction....Pages 173-185 Organisation of the Urodynamic Unit....Pages 186-197 Back Matter....Pages 198-341