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In cases of complex voiding dysfunction, videourodynamics can be invaluable (Fig. 14). BEDSIDE CYSTOMETRICS In cases where very basic urodynamic information such as sensation, capacity, and presence of detrusor contractions (voluntary or involuntary) is desired, a very simple CMG,known as bedside or eyeball urodynamics, canbe performed without any special urodynamic equipment. The urodynamicinformation provided, although limited, is sometimes enough to aid in malung a differential diagnosis (36).
Catheter 14-18 French is introduced into the bladder and postvoid residual is measured. A Foley catheter may be used if occlusion of the bladder neck is necessary or if one is already indwelling. A catheter tip syringe (usually 60 mL) is connected to the end of the catheter after its plunger is removed. Thecatheter and attached syringe are held directly upright and the top of the syringe is usually located about 15-20 cm above the patient's bladder (Fig. 15). L increments as water or saline is poured into the syringe.
In these cases, the bladder is filled with radiographic contrast filling during urodynamics. Because all urodynamic parameters previously mentioned are visualized simultaneously with the radiographic appearance of the lower urinary tract, the clinician can better appreciate their interrelationships and recognize artifacts. Videourodynamics is the most precise way to evaluate lower urinary 49 ChapterEvaluation 2 / Diagnostic UDS-l20 ................................ J I I I I I I I ~ I I I I I I I I I 1 I I I I ~ I I I I I I *;til l ..