Synchronous cine/pressure/flow cystography: a method of routine urodynamic investigation

s Difficulty may be experienced by clinicians in the interpretation of histories suggestive of disorders of the bladder or its outflow tract. This paper describes in some detail apparatus for synchronous combined pressure/flow cystographic recording during micturition, which at relatively small expense can be incorporated with standard fluoroscopic equipment. Also described is the method of performance of the investigation developed during a critical experience of over 1,000 studies; during this time the test has been simplified as much as possible and the radiation dose kept within the range used for a single pyelographic examination. Artefacts are discussed and methods for their detection suggested. Of particular diagnostic importance is the incorporation of electrical subtraction which gives an indication of the activity of the detrusor muscle. The method is of particular value in the distinction of stress and urge incontinence, neurological dysfunction, and the elucidation of symptoms after operations on the bladder or outflow tract.