Functional Assessment of the Bladder

  1. Greg Bock Organizer and
  2. Julie Whelan
  1. Jørgen Nordling

Published Online: 28 SEP 2007

DOI: 10.1002/9780470513941.ch8

Ciba Foundation Symposium 151 - Neurobiology of Incontinence

Ciba Foundation Symposium 151 - Neurobiology of Incontinence

How to Cite

Nordling, J. (2007) Functional Assessment of the Bladder, in Ciba Foundation Symposium 151 - Neurobiology of Incontinence (eds G. Bock and J. Whelan), John Wiley & Sons, Ltd., Chichester, UK. doi: 10.1002/9780470513941.ch8

Author Information

  1. Department of Urology, H111, Herlev Hospital, University of Copenhagen, DK-2730 Herlev, Denmark

Publication History

  1. Published Online: 28 SEP 2007

ISBN Information

Print ISBN: 9780471926870

Online ISBN: 9780470513941

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Keywords:

  • functional assessment;
  • bladder;
  • cystometry;
  • detrusor function;
  • denervation supersensitivity

Summary

The urinary bladder has two functions: to store and to empty. A frequency–volume chart completed by the patient provides useful information about voiding intervals, possible factors provocative for incontinence, functional bladder capacity and daily urine volume. Filling cystometry is used primarily to evaluate reflex function in the storage phase, giving information about the presence or absence of detrusor instability and (in combination with urethral EMG) about detrusor–sphincter coordination. Information is also obtained about bladder sensation, bladder capacity and bladder compliance. Detrusor function during emptying is closely related to outflow conditions and therefore demands simultaneous registration of detrusor pressure and urinary flow rate. An inverse relation exists between detrusor pressure and flow rate, which means that reduced flow rate causes increased detrusor pressure for the same detrusor power. Under-active detrusor function will result in low detrusor pressure and low flow rate. The finding of a non-contractile detrusor may indicate psychogenic inhibition or a neurogenic lesion. Sacral evoked potentials and denervation supersensitivity tests may help to distinguish between these conditions.