Cystometry

Cystometry, also known as cystometrogram, is a clinical diagnostic procedure used to evaluate the function of the urinary bladder. This test measures how much urine the bladder can hold, how much pressure builds up inside the bladder as it stores urine, and how full it is when you start to feel the urge to urinate. Cystometry is a key component of urodynamic testing, which assesses the dynamic interactions between the bladder's capacity to store and evacuate urine and the urethra's ability to close and open.

Indications

Cystometry is indicated for patients experiencing symptoms suggestive of lower urinary tract dysfunction, such as:

• Urinary incontinence
• Frequent urination
• Painful urination
• Difficulty starting urination
• Incomplete bladder emptying
• Neurogenic bladder disorders

Procedure

The cystometry procedure involves the following steps:

1. The patient's bladder is emptied.
2. A catheter is inserted into the bladder through the urethra, and another catheter may be placed in the rectum to measure abdominal pressure.
3. The bladder is slowly filled with water or, less commonly, gas, while measurements are taken of the pressure inside the bladder and the sensation experienced by the patient.
4. The patient is asked to indicate when they first feel the urge to urinate and when that urge becomes strong.
5. The volume of fluid at these points is recorded, along with the corresponding bladder pressures.

Interpretation

The data obtained from cystometry can help diagnose several conditions, including:

• Detrusor overactivity or instability, characterized by involuntary bladder contractions during the filling phase
• Bladder compliance issues, indicating how well the bladder can expand in response to increased urine volume
• Urinary retention, reflecting an inability to empty the bladder completely
• Sensory disorders, where there is a reduced or increased sensation of bladder filling

Risks and Complications

Cystometry is generally safe, but it may involve some risks and complications, such as:

• Urinary tract infections (UTIs)
• Discomfort or pain during the procedure
• Bleeding
• Bladder spasms

Conclusion

Cystometry is a valuable diagnostic tool in the field of urology, providing essential information about bladder function. It aids in the diagnosis and management of various urinary disorders, contributing to the development of personalized treatment plans for patients experiencing lower urinary tract symptoms.