Fundamentals of urodynamic practice, based on International Continence Society good urodynamic practices recommendations
Fundamentals of urodynamic practice, based on International Continence Society good urodynamic practices recommendations
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DOI：
10.1002/nau.23773
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发表时间：
2018-08-01
影响因子：
2
通讯作者：
Gammie, Andrew
中科院分区：
文献类型：
--
作者：
Drake, Marcus J.;Doumouchtsis, Stergios K.;Gammie, Andrew
目的 回顾国际尿控协会 (ICS) 标准化文件中关于基本尿动力学测试的建议，明确临床实践中实施和解释的关键建议。方法确定并总结了 ICS 标准中描述的关于良好尿动力学实践、尿动力学设备和下尿路 (LUT) 功能术语的基本期望。结果 ICS 标准尿动力学方案包括临床病史（包括症状和不适评分）、检查、3 天排尿图表/日记、具有排尿后残留的代表性尿流测量、以及具有压力流量研究 (PFS) 的膀胱测量。充满液体的导管连接到压力传感器，其垂直压力与患者耻骨联合相同，以大气压力为零值。进行尿动力学测试是为了回答特定治疗驱动的治疗选择问题；激发是为了在测试期间提供重现问题的最佳机会。全程监控记录质量，并对测试过程中出现的任何技术问题采取补救措施。在测试过程中贴上标签来记录事件，例如患者报告的感觉、激发测试和作废许可。测试后，对压力和流量轨迹进行仔细检查，以确保人工制品不会混淆结果。 ICS 标准尿动力学报告详细介绍了关键方面，报告临床观察、技术和质量问题。尿动力学服务必须根据制造商的规定维护和校准设备。结论该审查提供了对提供符合适当标准的膀胱测压和压力流量研究 (PFS) 的尿动力学单位的实践期望的简洁总结。
AimsTo review the recommendations on basic urodynamic testing in the International Continence Society (ICS) standardization documents, specifying key recommendations for delivery and interpretation in clinical practice.MethodsFundamental expectations described in the ICS standards on good urodynamic practices, urodynamic equipment, and terminology for lower urinary tract (LUT) function were identified and summarized.ResultsThe ICS standard urodynamic protocol includes clinical history, including symptom and bother score(s), examination, 3-day voiding chart/diary, representative uroflowmetry with post-void residual, and cystometry with pressure-flow study (PFS). Liquid filled catheters are connected to pressure transducers at the same vertical pressure as the patient's pubic symphysis, taking atmospheric pressure as the zero value. Urodynamic testing is done to answer specific therapy-driven questions for treatment selection; provocations are applied to give the best chance of reproducing the problem during the test. Quality of recording is monitored throughout, and remedial steps taken for any technical issues occurring during testing. Labels are applied during the test to document events, such as patient-reported sensation, provocation tests, and permission to void. After the test, the pressure and flow traces are scrutinized to ensure artefacts do not confound the findings. An ICS standard urodynamic report details the key aspects, reporting clinical observations, technical, and quality issues. Urodynamic services must maintain and calibrate equipment according to manufacturer stipulations.ConclusionsThe review provides a succinct summary of practice expectations for a urodynamic unit offering cystometry and pressure flow studies (PFS) to an appropriate standard.