Dear colleagues,
We want to share with you an interesting
Urodynamic case.
You can send us your comments with your
diagnostic impression and your therapeutic options.
We do have a clinical and Urodynamic follow-up
that will be published in the next weeks.A 77 year old woman had undergone a Reemex surgery (adjustable sling) 2 weeks before. She had undergone a colposuspension 10 years ago, with recurrence of her incontinence in the last 2 years.
She had a Urodynamic study performed 2 years
ago elsewhere that was reported as a stable bladder with leakage with cough and
a normal emptying phase, with no postvoid residual.
Her surgeon did not consider to update the
study and performed the Reemex procedure without complications.
She had acute retention after the
procedure, despite Immediate lowering of the sling tension. Due to
persistent difficulty, an indwelling catheter was placed and she was referred
for Urodynamics after 4 days of bladder cycling:
Uroflowmetry: no flow was produced .
Cystometry
 |
Cystometric capacity 61 ml
Pdet @ cys cap 33cmH2O
Involuntary contraction causing leakage
|
Pabd
Pves
Pdet
V inf
V ura
Q ura
P/F Study
 |
Pdet @ Qmax 32 cmH2O
Qmax 3ml/s
PVR 45 ml
|
Can you please give us your diagnostic
impression?
- Cystometry- Pressure/ flow study
What treatment would you recommend?
