Urodynamic investigation apparatus, system and methods
A urodynamic investigation apparatus for receipt of urine from a bladder is provided. The apparatus is characterized by a tubular element, first and second fittings, and a sleeve element, for select passage of urine there through, within the tubular element. The tubular element is characterized by opposing first and second end portions, and a port. The fittings are adapted to be received by the opposing end portions of the tubular element so as to delimit an apparatus chamber. The sleeve element, suspended between the fittings within the chamber, has collapsed and open configurations. The collapsed configuration is indicative of a no urine flow condition, and the open configuration indicative of a urine flow condition, with the sleeve element urine flow condition being a function of pressure applied to the chamber via the port of the tubular element.
1. An improved urodynamic pressure profiling method comprising the steps of:
a. applying a first pressure about a lumen of a urodynamic investigation apparatus carrying urine discharge from a bladder without terminating urine flow through the lumen;
b. determining a urine flow rate corresponding to the first applied pressure;
c. applying a second pressure about the lumen of the urodynamic investigation apparatus carrying urine discharge from the bladder without terminating urine flow through the lumen, the second pressure greater or less than the first pressure by a select pressure increment; and,
d. ascertaining, via an assessment of applied pressures and corresponding flow rates, either or both of an applied pressure corresponding to a no flow urine condition and a maximum urine discharge flow rate corresponding to an application of no pressure about the lumen.
2. The method of claim 1 wherein applied pressures are within a select pressure range.
3. The method of claim 1 wherein applied pressures are within a pressure range of about 30 to 60 centimeters of water.
4. The method of claim 1 wherein the select pressure increment comprises 10 centimeters of water.
5. The method of claim 1 further comprising measuring abdominal surface electromyography concurrent with pressure application to the lumen carrying urine discharge from the bladder.
6. An enhanced urodynamic pressure profiling method comprising the steps of:
a. applying a first positive pressure about a lumen of an extracorporeal device carrying urine discharge from a bladder without terminating urine flow through the lumen, the extracorporeal device comprised of a rigid plastic tubular element having a fitting adapted for cooperative engagement with periurethral tissue;
b. determining a urine flow rate corresponding to the first applied positive pressure; and,
c. measuring and recording abdominal surface electromyography concurrent with positive pressure application to the lumen carrying urine discharge from the bladder.
7. The method of claim 6 wherein the first applied pressure is less than the second applied pressure.
8. The method of claim 6 wherein the first applied pressure is greater than the second applied pressure.
9. The method of claim 6 wherein the first applied pressure and the second applied pressure are applied as either of an increasing/decreasing pressure cycle.
10. The method of claim 9 wherein the systematic increasing/decreasing pressure cycle for pressure application comprises fixed increment pressure application changes.
11. The method of claim 9 wherein the systematic increasing/decreasing pressure cycle for pressure application comprises incremental pressure application changes of 10 centimeters of water.
12. A non-invasive pressure flow study for patients exhibiting one or more lower urinary tract symptoms, the study comprising the steps of:
a. providing an extracorporeal device comprising a rigid plastic tubular element and a sleeve element traversing a chamber of the rigid plastic tubular element, the device adapted such that a select application of pressure to the chamber influences urine passage into and/or through the sleeve element;
b. applying a series of pressures about the sleeve of the extracorporeal device carrying urine discharge from a bladder during a void event without terminating urine flow through the sleeve;
c. determining a urine flow rate resulting from applied pressures of said series of applied pressures; and,
d. ascertaining, via an assessment of applied pressures and resulting urine flow rates of said series of applied pressures, either or both of an applied pressure corresponding to a no flow urine condition and a maximum urine discharge flow rate corresponding to an application of no pressure to the lumen.
13. The method of claim 12 further comprising measuring abdominal surface electromyography concurrent with pressure application to the lumen carrying urine discharge from the bladder.