Terminology and Abbreviations 

Terminology

  • Abdominal leak point pressure: the intravesical pressure at which urine leakage occurs due to increased abdominal pressure in the absence of a detrusor contraction. [Abrams 2002]
  • Acontractile detrusor: one that cannot be demonstrated to contract during urodynamic studies. [Abrams 2002]
  • Areflexic bladder = flaccid bladder = acontractile detrusor
  • Aseptic intermittent catheterization: use of a sterile technique. This implies genital disinfection and the use of sterile catheters and instruments/gloves. [Abrams 2002]
  • Autonomic dysreflexia: A syndrome associated with damage to the spinal cord above the mid thoracic level characterized by a marked increase in the sympathetic response to minor stimuli such as bladder or rectal distention.
  • Benign prostatic hyperplasia: a term used (and reserved for) the typical histological pattern which defines the disease. [Abrams 2002]
  • Bladder capacity (cystometric capacity): the bladder volume at the end of the filling cystometrogram, when “permission to void” is usually given. The end point should be specified, for example, if filling is stopped when the patient has a normal desire to void. The cystometric capacity is the volume voided together with any residual urine. [Abrams 2002]
  • Bladder compliance: the relationship between change in bladder volume and change in detrusor pressure. Compliance is calculated by dividing the volume change (V) by the change in detrusor pressure (pdet) during that change in bladder volume. It is expressed in ml/cm H2O. [Abrams 2002]
  • Bladder diary: This records the times of micturitions and voided volumes, incontinence episodes, pad usage and other information such as fluid intake, the degree of urgency and the degree of incontinence. The following measurements can be abstracted from frequency volume charts and bladder diaries: [Abrams 2002]
  • Bladder expression: various maneuvers aimed at increasing intravesical pressure in order to facilitate bladder emptying. The most commonly used maneuvers are abdominal straining, Valsalva’s maneuver and Crede´ maneuver [Abrams 2002]
  • bladder neck: A junctional portion between bladder and the urethra (-> link to the BC-1. Normal anatomy/ Urinary bladder)
  • Bladder outlet: composed of the bladder base, urethra, and external urethral sphincter
  • Bladder reflex triggering: various maneuvers performed by the patient or the therapist in order to elicit reflex detrusor contraction by exteroceptive stimuli. The most commonly used maneuvers are suprapubic tapping, thigh scratching and anal/rectal manipulation. [Abrams 2002]
  • Catheterization: a technique for bladder emptying employing a catheter to drain the bladder or a urinary reservoir. [Abrams 2002]
  • Cauda equina syndrome: Impairment of the nerves in the cauda equina, the bundle of spinal nerve roots that arise from the lower end of the spinal cord. Characterized by dull pain in the lower back and upper buttocks and lack of feeling (analgesia) in the buttocks, genitalia and thigh, together with disturbances of bowel and bladder function.
  • Clean intermittent catheterization: use of a clean technique. This implies ordinary washing techniques and use of disposable or cleansed reusable catheters. [Abrams 2002]
  • Detrusor leak point pressure: the lowest bladder pressure in the absence of a detrusor contraction at which leakage occurs across the urethra. [Webster 2002]
  • Detrusor overactivity: a urodynamic observation characterised by involuntary detrusor contractions during the filling phase which may be spontaneous or provoked. [Abrams 2002]
  • Detrusor pressure: component of intravesical pressure that is created by forces in the bladder wall (passive and active). It is estimated by subtracting abdominal pressure from intravesical pressure. [Abrams 2002]
  • Detrusor sphincter dyssynergia: a detrusor contraction concurrent with an involuntary contraction of the urethral and/or periurethral striated muscle. Occasionally, flow may be prevented altogether. [Abrams 2002]
  • Detrusor underactivity: a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span. [Abrams 2002]
  • Detrusor: the muscularis of the bladder
  • Enuresis: any involuntary loss of urine. If it is used to denote incontinence during sleep, it should always be qualified with the adjective “nocturnal”. [Abrams 2002]
  • Feeling of incomplete emptying: a self-explanatory term for a feeling experienced by the individual after passing urine. [Abrams 2002]
  • Filling cystometry: the method by which the pressure/volume relationship of the bladder is measured during bladder filling. [Abrams 2002]
  • Frequency volume chart: this records the volumes voided as well as the time of each micturition, day and night, for at least 24 hours. [Abrams 2002]
  • Frequency: the complaint by the patient who considers that he/she voids too often by day. [Abrams 2002]
  • Guarding reflex: increase in striated sphincter EMG activity during filling, it guards against incontinence.
  • Hesitancy: the term 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. [Abrams 2002]
  • hyperreflexic bladder = automatic bladder, detrusor overactivity
  • Incidence: the annual number of people who have a case of the condition
  • Indwelling catheterization: an indwelling catheter remains in the bladder, urinary reservoir or urinary conduit for a period of time longer than one emptying. [Abrams 2002]
  • Intermittent catheterization: drainage or aspiration of the bladder or a urinary reservoir with subsequent removal of the catheter. It is usually performed by an attendant (e.g. doctor, nurse or relative) [Abrams 2002]
  • Intermittent self-catheterization: Intermittent catheterization performed by the patient himself/herself [Abrams 2002]
  • Intermittent stream (Intermittency): the term used when the individual describes urine flow which stops and starts, on one or more occasions, during micturition. [Abrams 2002]
  • Intravesical pressure: the pressure within the bladder, usually measured with pressure transducer during urodynamic study in filling and voiding phase.
  • Maximum urethral closure pressure (MUCP): the maximum difference between the urethral pressure and the intravesical pressure. [Abrams 2002]
  • Meningomyelocele: = myelomeningocele. Hernial protrusion of the spinal cord and its meninges through a defect in the vertebral column.
  • Mixed urinary incontinence: the complaint of involuntary leakage associated with urgency and also with exertion, effort, sneezing or coughing. [Abrams 2002]
  • Myelodysplasia: defective development of any part of the spinal cord
  • Nocturia: the complaint that the individual has to wake at night one or more times to void. [Abrams 2002]
  • Nocturnal enuresis is the complaint of loss of urine occurring during sleep. [Abrams 2002]
  • Non-relaxing urethral sphincter obstruction usually occurs in individuals with a neurological lesion and is characterised by a non-relaxing, obstructing urethra resulting in reduced urine flow. [Abrams 2002]
  • Paraplegia: paralysis of the lower part of the body including the legs
  • Post micturition dribble: the term 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. [Abrams 2002]
  • Post void residual (PVR) is defined as the volume of urine left in the bladder at the end of micturition. [Abrams 2002]
  • Prevalence: the total number of cases of a specific disease in existence in a given population at a certain time
  • Retention of urine, acute: a painful, palpable or percussible bladder, when the patient is unable to pass any urine. [Abrams 2002]
  • Retention of urine, chronic: a nonpainful bladder, which remains palpable or percussible after the patient has passed urine. Such patients may be incontinent. [Abrams 2002]
  • rhabdosphincter: a sphincter counting of striated muscle fibers. An integral component of the urethral muscularis in both genders, independently of and separate from outlying striated musculature of the pelvic floor [Miller 1996]
  • Skeletal muscle: striated muscle that are attached to bones and typically cross at least one joint.
  • Slow stream: reported by the individual as his or her perception of reduced urine flow, usually compared to previous performance or in comparison to others. [Abrams 2002]
  • smooth muscle sphincter: the bladder neck itself, the trigone, or a related circular ring is considered as a smooth muscle sphincter [Miller 1996]
  • smooth muscle: One of the three types of muscle tissue in the body (skeletal, smooth, cardiac). Forms hollow internal organs including urinary bladder. So named because of the absence of microscopic lines called "cross-striations" which are seen in the other two types.
  • Spinal shock: A period for decreased excitability of spinal cord segments with a suppression of autonomic activity as well as somatic reflex activity (flaccid muscle paralysis) at or below the level of injury ater a significant SCI or trauma to the spinal cord, or roots
  • Straining to void: the muscular effort used to either initiate, maintain or improve the urinary stream. [Abrams 2002]
  • Stress urinary incontinence: the complaint of involuntary leakage on effort or exertion, or on sneezing or coughing. [Abrams 2002]
  • striated muscle: any muscle whose fibers are divided by transverse bands into striations, including cardiac and voluntary muscle; often used as a synonym for voluntary muscle
  • Terminal dribble: the term used when an individual describes a prolonged final part of micturition, when the flow has slowed to a trickle/ dribble. [Abrams 2002]
  • Tetraplegia: patients with a spinal cord injury are designated as having tetraplegia (preferred to quadriplegia) or paraplegia. Tetraplegia refers to injuries to the cervical spinal cord and paraplegia refers to injuries below the cervical spinal cord.
  • Urethral pressure profile: a graph indicating the intraluminal pressure along the length of the urethra. [Abrams 2002]
  • Urge urinary incontinence: the complaint of involuntary leakage accompanied by or immediately preceded by urgency. [Abrams 2002]
  • Urgency: the complaint of a sudden compelling desire to pass urine which is difficult to defer.
  • Urinary incontinence: the complaint of any involuntary leakage of urine. [Abrams 2002]
  • Urodynamic study, fluoroscopic: functional and anatomical study involving the standard urodynamic study and fluoroscopic monitoring Video (fluoroscopic) urodynamic evaluation)
  • Urodynamic study: the dynamics of the propulsion and flow of urine in the urinary tract. It usually refers to the functional study involving the measurement of the pressure(s) of urinary bladder and the lower urinary tract during the filling and emptying phase of the bladder.
  • Valsalva leak point pressure: the pressure that causes leakage of urine in the absence of a bladder contraction. [Webster 2002 (link to Dx-3. Urodynamic evaluation in SCI /Valsalva Leak Point Pressure (VLPP))
  • Voiding symptoms: experienced during the voiding phase. [Abrams 2002

Common Abbreviation

  • AD: autonomic dysreflexia
  • DH: detrusor hyperreflexia
  • DLPP: detrusor leak point pressure
  • DSD: detrusor-sphincter dyssynergia
  • LPP: leak point pressure
  • UTI: urinary tract infection
  • VLPP: Valsalva leak point pressure
  • VUR: vesicoureteral reflux
  • UDS: urodynamic study
  • CNS: Central nervous system
  • PNS: peripheral nervous system

References

  • Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A; Standardisation Sub-committee of the International Continence Society. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002;21(2):167-78.
  • Webster GD, Guralnick ML. The neurourologic evaluation. In: Walsh PC, Retik AB, Vaughan Jr, ED, Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (editors). Campbell’s Urology 8th ed. Philadelphia 2002;900-30.
  • Dorland’s illustrated medical dictionary, 29th ed. 2000, W.B. Saunders Company, Philadelphia. PA
  • Miller ER. Physiology of the lower urinary tract. Urol Clin North Am. 1996 May;23(2):171-5.

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