Question 10#

The urodynamic trace below

demonstrates the following feature:

A. The voiding phase is normal
B. There are no cough tests on this trace
C. The abdominal line is not functioning well
D. Classical sawtooth appearance of neurogenic detrusor overactivity with sustained high pressure contraction
E. More than 500 mL have been instilled

Correct Answer is D


Answer D

The safety of the patient should be paramount during the study. There should be careful assessment of the patient’s ability to sit and stand safely and this should be documented in the report. The investigator should understand the phenomenon of autonomic dysreflexia (AD) and be competent to treat this life-threatening condition.

It is recommended to start filling at 20 mL/min with body warm fluid. This trace demonstrates a classical pattern of neurogenic detrusor overactivity and if accompanied with a video clip would have shown sphincter dyssynergia. There is a cough test in the beginning of the study with good subtraction. Ideally, the cough should be performed after every minute and at the end of the study to ensure optimal functioning of the lines. Although not clearly marked, it is unlikely more than 500 mL has been instilled in the bladder.