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Uro/Gynecology

• Editor's Note
• List of Articles

List of Articles

• Urodynamic Assessment: Electromyography
  Presentation of pelvic floor electrodiagnostic techniques including surface and needle electromyography (EMG), nerve conduction and terminal latency studies, evoked potentials, and reflex response studies. The clinical, urodynamic, and electrophysiologic findings to be expected with neuropathy in various areas, from the cerebral cortex to the peripheral pelvic floor nerves, are also described. Because of widespread technical advances and great increase in the amount of information about human neuro-urology, concepts are continually undergoing modification and change. This chapter also concentrates on the present aspects of clinically useful knowledge, although modification of many concepts will soon be needed. EMG requires additional expertise but should be considered in the difficult clinical situation.
  
  
• Pitfalls in Urodynamic Studies Interpretation
  Urodynamic studies provide insight into the functioning of individual components of the lower urinary tract, bladder, and urethra, and into their interactions. Debate continues on the role of urodynamic studies in prediction of surgical outcome and in patient counseling before surgery. The purpose of this review is to set forth general principles of pitfalls in urodynamic studies and illustrate with a few representative tracings. The refinement of urodynamic techniques, in the context of rapidly evolving strategies to treat stress urinary incontinence, pelvic-organ prolapse and overactive bladder, has allowed physicians caring for women with disorders of the pelvic floor to bladder function more accurately. This review also highlights some of the ongoing debates over the performance, interpretation, and utility of urodynamic testing, and provides references for further reading on these topics. Problems arise if the urodynamic studies are of poor quality or difficult to interpret, and if repeat testing is required.
  
  
• Health Implications of Urinary Incontinence in Women
  Understanding the best available evidence for evaluating and treating urinary incontinence in women with a focus on overactive bladder (OAB). Prevalence of incontinence appears to increase gradually during young adult life, has a broad peak around middle age, and then steadily increases in the elderly. After the basic evaluation of urinary incontinence, simple cystometry is appropriate for detecting abnormalities of detrusor compliance and contractibility, measuring postvoid residual volume, and determining capacity. The differential diagnosis including genito-urinary and non-genito-urinary conditions and their various managements are also discussed. Although pharmacologic and non-pharmacologic therapies are effective in reducing urge incontinence, neither is curative in some patients.
  
  
• Urinary Incontinence: Introduction & Behavior Modification
  There are various types of incontinence and the role of behavior modification. Overactive bladder (OAB) / urge incontinence is a common condition that becomes even more prevalent as people age. It is associated with significant psychological and physical morbidity as well as increased healthcare costs. The prevalence of stress incontinence represents a spectrum, depending on how incontinence is defined. There is racial and ethnic variation in the prevalence of urinary incontinence in women.
  
  

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