Low-Cost Urodynamic Studies: A Valuable Diagnostic Tool for Rural Practitioners

INTRODUCTION

A cystometrogram or CMG, also known as a urodynamic study, means a bladder pressure study, in plain English. It is a very useful diagnostic tool in patients having lower urinary tract symptoms (1). It is considered a sophisticated test, and it involves a complex machine (2). We describe a simple method of doing similar testing in remote and rural areas, by using two infant feeding tubes that are inserted into the bladder. One is used for measuring the bladder pressure, and the other one for filling the bladder. We describe a low-cost method of carrying out bladder pressure studies.

THE INDICATIONS AND USES OF THE STUDY
About a third of the spinal cord nerves go to the urinary bladder and are involved in the control of the bladder’s function. Neurovesical dysfunction is a common, under-evaluated condition. CMG is required for its evaluation. The maximum voiding pressure gives objective evidence of bladder outflow obstruction, especially with benign prostatic hypertrophy. The indications of CMG are as follows:

A. Evaluation of lower urinary tract symptoms: These symptoms are hesitancy, poor stream, a sensation of incomplete voiding, urgency, increased frequency, nocturia, etc.
B. Evaluation of bladder outflow obstruction due to benign prostatic hyperplasia
C. Follow-up of treatment for neurovesical dysfunction and for bladder outflow obstruction

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