Urology & Urogynecology > Education and Reference

CLINICAL APPLICATION NOTES

Introduction to Urodynamics II: Clinical Indications and Preparation

Voiding Symptoms

Voiding symptoms are most frequently presented by the male patient, are experienced during the voiding phase and are defined by the ICS as follows:

Symptom	ICS Definition
Slow stream	Reported when the individual perceives reduced urine flow, usually compared to previous performance or in comparison to others.
Splitting/spraying	Reported perception of an abnormal (splattering, splitting or spraying) urine stream.
Intermittency	Used when the individual describes urine flow that stops and starts, on one or more occasions, during micturition.
Hesitancy	Used when an individual describes difficulty in initiating micturition, resulting in a delay in the onset of voiding after the individual is ready to pass urine.
Straining to void	Describes the muscular effort used to initiate, maintain or improve the urinary stream.
Terminal dribble	Used when an individual describes prolonged final part of micturition, when the flow has slowed to a trickle/dribble.
Pain	Is also experienced during voiding and is described as on the previous page.

Post-Micturition Symptoms

Post-micturition symptoms are experienced immediately after micturition and are defined by the ICS as follows:

SYMPTOM	ICS DEFINITION
Feeling of incomplete emptying	Self-explanatory term for a feeling experienced by the individual after passing urine.
Post-micturition dribble	Used when an individual describes the involuntary loss of urine immediately after he or she has finished passing urine, usually after leaving the toilet in men, or after rising from the toilet in women.

Causes of Symptoms
The urodynamic evaluation is a tool that can help determine the cause(s) of the reported symptoms. Causes include:
Side effects of medications Mechanical obstruction “Diversionary” diseases Neuromuscular diseases Metabolic diseases	Infections diseases Neurologic injury The aging process Poor bladder habits

Intro to Urodynamics TOC