Singlechannel Cystometry

Cystometry can be performed as a single-channel study in which the intravesical pressure [the pressure within the bladder (Pves)] is measured during filling and storage. It consists of a Foley catheter in the bladder attached to a wide-mouthed syringe without plunger and held at the level of the superior edge of the pubic symphysis. Saline is incrementally poured into the syringe and thus by retrograde flow into the bladder. The height of the saline column indicates the pressure of the tonic segment of the cysto-metric curve. A detrusor contraction during bladder filling results in a rapid increase in the saline column. With this technique, the monitored pressure is the intravesical pressure (Pves). This reflects the cumulative effects of all sources of pressure on the bladder, namely, intraabdominal pressure (i.e., the pressure surrounding the bladder) and detrusor pressure (i.e., the pressure derived from active and passive bladder wall smooth muscle activity). With single-channel recording, it is difficult to ascertain the exact source of the increase in Pves, caused by either detrusor contraction or increased intraabdominal pressure (e.g., cough or patient movement). To distinguish the source of the increased Pves, the patient should be asked

Figure 3-2.3. Multichannel cystometry showing normal CMG.

to hold his or her breath, or multichannel cystometry should be performed.

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