Urological investigations Flashcards
What is often part of the initial evaluation of patients complaining of LUTS?
Bladder diary
Bladder diary showing increased frequency and normal volumes?
Suggests a high fluid intake/output e.g. diabetes, people who habitually drink a lot of water
Bladder diary showing reduced volumes, with minimal variation in volume voided?
Suggests bladder wall pathology such as carcinoma in situ or interstitial cystitis
Bladder diary showing reduced volumes with variation in the volume voided?
Suggests underlying detrusor overactivity
Non-invasive test which measures the rate of flow of voided urine?
Uroflowmetry
Uroflowmetry graph with:
a) rapid rise to maximum high-flow peak;
b) slow rise, prolonged variable flow;
c) prolonged flow with little variability, giving a plateau curve
a) normal urinary flow
b) outflow obstruction
c) urethral stricture
How is uroflowmetry performed?
Patients void normally with a comfortably full bladder;
Flow meter measures volume/time, expressed as ml/sec
What is the minimum flow volume required for reliable interpretation?
150ml
Men under the age of 40 generally have a flow rate of..?
over 25ml/sec
Men over the age of 60 with no obstruction generally have a flow rate of..?
over 15ml/sec
How is post-void residual volume measured?
Ultrasound scan after voiding
When might ultrasound PVR measurement be useful?
In patients with urgency- to see if anti-muscarinic can be given
In patients with recurrent UTI
In patients with urinary incontinence
What does cystometry measure?
The bladder pressure, the detrusor pressure and the abdominal pressure
What can cystometry be used to distinguish between?
Stress, urge and mixed incontinence
Main serum marker for the detection of prostate cancer?
Prostate specific antigen
