Treatments & Therapies

Cystometry – treatment, effect and risks

Zystometrie

Cystometry is a diagnostic procedure in the field of urology . The bladder is filled with saline solution and contrast medium and the pressure inside the bladder is measured. These measurements are taken at rest and under stress. Furthermore, the measurements are carried out with different filling values. Based on the results, therapeutic measures can be appropriately tailored to the diagnosis.

What is cystometry?

Cystometry is a procedure to make or rule out a diagnosis of disorders in the emptying and filling of the urinary bladder. The procedure is designed to measure and assess bladder pressure in relation to volume and patient perception.

The measurement results provided information about the muscle function of the pelvic floor muscles and the sphincter and the neurological function of the nerves . The measurement relates not only to the bladder, but also to the function of the urinary tract.

As a physiological reaction to a full bladder, stimulus impulses are sent to the brain via the nerve tracts in order to initiate emptying of the bladder. These stimuli can be processed voluntarily by humans, which means that it is possible to hold urine for a certain period of time. If the urinary bladder continues to fill and is not emptied, despite the continuous stimulation, reflex emptying of the bladder can occur.

However, if the bladder is emptied voluntarily, feedback impulses are sent and the bladder contracts and the sphincter opens.

If this physiological process is disturbed, urinary incontinence or urinary stasis can occur. In order to analyze and assess the cause of this, the procedure of cystometry is used. Cystometry is often performed in combination with other examination methods of uroflowmetry .

Function, effect & goals

Cystometry is used for various problems affecting the urinary bladder. This diagnostic procedure is often used in the case of urinary incontinence, bladder emptying disorders, unclear symptoms such as frequent urge to urinate with little or no urination, reflux of urine from the bladder into the kidneys , unclear urinary stasis and in children who are therapy-resistant with bedwetting . Bladder emptying disorders due to neurological diseases or after damage to the spinal cord are also assessed with the help of cystometry.During a cystometry, the bladder pressure is measured during filling. Data on the dynamics of the urinary bladder, volume capacity, elasticity and stability are recorded.

Before cystometry can be performed, cystitis must be ruled out, as it is contraindicated for such an examination. During cystometry, a transurethral catheter is then placed through the urethra into the bladder. The urinary bladder is filled with saline solution via this thin catheter. Furthermore, via the rectuma transanal catheter was inserted. The pressure behavior during the filling and emptying of the bladder is continuously recorded via this measuring catheter. Pressure is measured at rest and under stress, such as when coughing. The values ​​are recorded as a so-called pressure curve and can provide information as to whether there is a possible disturbance in the area of ​​the bladder muscles or the activity of the sphincter muscle.

By evaluating the cystometry, forms of incontinence can be ruled out and a diagnosis can be made. A distinction is made between stress incontinence, urge incontinence, high-pressure bladder, overactive bladder with a possible neurological cause and mixed urinary incontinence. Based on these measurement results and the exclusion of various disorders, an adequate diagnosis-oriented therapy can be carried out. If the measurement results are not meaningful enough, especially in the case of disorders with a neurological background, it is advisable to integrate further examinations in the form of an ice water test or a carbachol test into the assessment of the cystometry. A pelvic floor EMG is often used to rule out benign prostate enlargementmade.

In the cystometries performed, a contrast agent is usually used to fill the bladder. This also enables a voiding cyturethrogram or video urodynamics. The speed of filling is individual and is divided into 3 levels. A slow filling rate is about 10m/min, a medium filling rate is 10-100ml/min and a fast filling rate is a value of over 100ml/min. For cystometry, it is recommended to start with a slow filling rate and then increase it.

Basically, a body-warm fluid is used for a general cystometry, only when a neurological cause of the symptoms is suspected, a cold fluid is used to provoke autonomic detrusor contractions. These contractions are physiologically inhibited by the supraspinal centers. If there is no detrusor contraction, this is an indication of a neurological disorder.

The general bladder capacity in women is 250-550ml. For men, a physiological filling volume of 350-750ml is specified.

Risks, side effects & dangers

Basically, cystometry is a very safe and complication-free procedure for detecting a possible disorder of the urinary bladder. Occasionally, however, a urinary tract infection can occur after the procedure.A so-called autonomic reflex can then occur in patients who suffer from symptoms of a bladder emptying disorder due to a neurological cause. This manifests itself in severe headaches , increased blood pressure , a low heart rate and profuse sweating . Cystometry should not be performed in patients with an acute urinary tract infection. Drugs that affect the flow of urine and the urinary bladder must be stopped before performing a cystometry. The attending specialist should discuss this with the patient before the procedure and weigh the risks individually based on the anamnesis and the course of the disease.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.