Abrams_Urodynamics_3rd_ed(1).pdf

Urodynamics

Paul Abrams

Urodynamics

Third Edition

With 152 Figures

Paul Abrams, MD, FRCS

Bristol Urological Institute

Southmead Hospital

Bristol

Artwork marked with symbol throughout the book is original to the 2nd edition (Abrams

P. Urodynamics, second edition, Springer London Ltd. 1997) and is being republished in this

3rd edition.

A catalogue record for this book is available from the British Library

Library of Congress Control Number: 2005932032

ISBN-10: 1-85233-924-1

ISBN-13: 978-1-85233-924-1

Printed on acid-free paper.

Apart from any fair dealing for the purposes of research or private study, or criticism or

review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may

only be reproduced, stored or transmitted, in any form or by any means, with the prior permis-

sion in writing of the publishers, or in the case of reprographic reproduction in accordance

with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning

reproduction outside those terms should be sent to the publishers.

The use of registered names, trademarks, etc. in this publication does not imply, even in the

absence of a speciﬁc statement, that such names are exempt from the relevant laws and regu-

lations and therefore free for general use.

Product liability: The publisher can give no guarantee for information about drug dosage and

application thereof contained in this book. In every individual case the respective user must

check its accuracy by consulting other pharmaceutical literature.

Printed in Singapore.

(Expo/KYO)

987654321

Springer Science+Business Media

springeronline.com

Preface

Lower urinary tract dysfunction produces a huge burden on sufferers in

particular and on society in general. Lower urinary tract symptoms have a

high prevalence in the community: 5% of children aged 10 wet the bed, while

15% of women and 7% of men have troublesome incontinence; and in elderly

men of 75, benign prostatic hyperplasia occurs in more than 80% of individu-

als, with benign prostatic enlargement coexisting in up to half this group and

half of these having bladder outlet obstruction.

The confusion felt in many people’s minds as to the role of urodynamics

has receded for the most part. The need to support the clinical assessment

with objective measurement has become accepted by most clinicians special-

ising in the care of patients with lower urinary tract symptoms (LUTS). Since

the ﬁrst edition of this book in 1983, urodynamics has become more widely

accepted. In the last 20 years the number of urodynamic units in Britain and

Europe has increased rapidly and almost every hospital of any signiﬁcance

embraces urodynamic investigations as an essential part of the diagnostic

armamentarium of the urology and gynaecology departments. Further,

specialists in geriatrics, paediatrics and neurology recognise the importance

of urodynamics in the investigation of a signiﬁcant minority of their

patients.

Despite the technological innovations that have seen the introduction of

computerised urodynamics, the development of neuro-physiological testing

and the introduction of new techniques such as ambulatory monitoring, the

objectives of this book remain unchanged. Urodynamics may appear compli-

cated, and one of the objectives of this book is to put the subject over simply

but in enough detail to allow urodynamic investigation to be accepted, on its

own merit, as a fundamental contribution to the management of many

patients. To do this means not only describing the tests but also showing in

which clinical areas they help management and in which they are pointless. It

means concentrating on the common clinical problems and on the presenting

symptom complexes, not the diagnosis; and it means pointing out any limita-

tions and possible artifacts of investigation.

We hope that a clinician with no previous experience in urodynamics will,

after reading this book, appreciate both the value and limitations of the

subject, and will have obtained the necessary practical advice on the use of the

appropriate equipment in the correct situations. Because this book is based on

personal experience, references in the text are relatively few.

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