CHAPTER I

INTRODUCTION

1.1 Background

The urinary tract is your body’s drainage system for removing urine. Urine

is composed of wastes and water. The urinary tract includes your kidneys, ureters,

and bladder. To urinate normally, the urinary tract needs to work together in the

correct order. Urologic diseases or conditions include urinary tract infections,

kidney stones, bladder control problems, and prostate problems, among others.

Some urologic conditions last only a short time, while others are long-lasting.1

Estimates of the global burden of disease indicate that diseases of the

kidney and urinary tract account for approximately 830,000 deaths and

18,467,000 disability-adjusted life years annually, ranking them 12th among

causes of death (1.4 percent of all deaths).2

As for 2012, according to statistics of urology disease in the United States

there are several conditions of urologic diseases that being analyzed which

divided into prostate (e.g. Benign prostatic hyperplasia, prostate cancer), bladder

(e.g. urinary incontinence, bladder stones), urethral disease (e.g. urethral

stricture), kidney (e.g. urinary tract stones), pediatric (vesicoureteral reflux,

urinary tract infections), male reproductive health (e.g. Erectile dysfunction) and

infections.1

Lower urinary tract symptoms (LUTSs) are classified as storage symptoms

(previously referred to as irritative symptoms) or voiding symptoms (previously

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referred to as obstructive symptoms).LUTS can be easier described as a result of

either a failure to store or a failure to empty.3 There are few diagnostic test that

can help in diagnosis such as imaging of the urinary tract and urodynamic

testing.1

Several problems could require imaging which can help the health care

provider in finding the causes. The health care provider can use several different

imaging techniques such as x-ray (cystography), ultrasound, MRI, and CT-Scan

depending on factors such as the person’s general medical history and urinary

tract symptoms. One symptom can have several possible causes. The health care

provider can use imaging techniques to determine, for example, whether a urinary

tract stone or an enlarged prostate is blocking urine flow. Imaging can help clarify

urinary tract infections (UTIs), urinary retention, small bladder capacity, and

urinary reflux, the backward flow of urine.1

As for x-ray, it is a minimally invasive procedure with rare complications.

Moreover, the imaging process is time consuming and inexpensive compared to

other alternatives. Extra care should be taken when undergo this procedure to

assure maximum safety for the patient by restricting the x-ray exposure to only

the part of the body being examined.1

Another diagnostic test for urologic disease is urodynamic examination. It

is a procedure that examine on how well the functions of the bladder, sphincters,

and urethra in storing and releasing urine. It focuses on the bladder’s ability to

hold urine and empty steadily and completely. Urodynamic tests can also show

whether the bladder is having involuntary contractions that cause urine leakage.1
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There are few types of urodynamic tests that the physician can choose as it

ranges from simple observation to precise measurement using advanced

instruments. Few types of urodynamic tests are uroflowmetry, postvoid residual

measurement, cystometric test, leak point pressure measurement and etc. The

urodynamic test results help diagnose the cause and nature of a lower urinary tract

problem.1

In order to have accurate diagnosis, the suitable diagnostic test should be

chosen and done by the physician. This will help in early further treatment and

can reduce morbidity thus avoid fatal condition and death. So, it is necessary to

collect some refferences and explanation about micturating cystography,

urodynamic examination and uroflowmetry.

1.2 Problem Identification

What is definition, procedure, indication and contraindication of

micturating cystography, urodynamic examination and uroflowmetry?

1.3 Aim

To get better understanding of definition, procedure, indication and

contraindication of micturating cystography, urodynamic examination and

uroflowmetry.