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Atlas of Urodynamics 2nd Edition PDF

Atlas of Urodynamics 2nd Edition PDF

Atlas of Urodynamics 2nd Edition PDF
Author Jerry G. Blaivas
File size 12 MB
Year 2007
Pages 256
Language English
File format PDF
Category Urology
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Book Description
A man complains of difficulty voiding. He is otherwise healthy. His urinalysis is normal and his prostate is large. Without knowing any more than that you can treat him with an alpha-adrenergic blocking agent and he has about a 50% chance of clinical improvement. If that fails you can do a transurethral prostatectomy and the chances of a successful outcome is probably about 75%. That’s pretty good and it doesn’t cost the health care system too much. But it’s pretty bad if you happen to be the patient in the 25% who does not have a successful outcome especially if you get worse afterwards. A woman complains of stress incontinence. She too is otherwise healthy and without knowing any more about her you do some kind of pubovaginal sling She’ll probably have a successful outcome too. Or maybe she’ll get worse. If you’re content with these kinds of results and if you’re content treating patients empirically you don’t need urodynamics. But if you want to know more about the subtle differences that distinguish one patient from another about why one patient fails and another succeeds why one patient does better with a medication or an operation and another with behavior modification urodynamics usually provides the answers. If you don’t routinely use urodynamics in our judgment both the patient and the doctor are disadvantaged. The patient is disadvantaged because deprived of a precise diagnosis treatment by definition must be empiric. Some patients will get empiric therapy that is doomed to failures; others may undergo surgery that is doomed to failure when another treatment is more appropriate. The doctor too is disadvantaged because he or she is deprived of the experience and knowledge that allows one to detect the subtle differences that distinguish one patient from another. If you treat patients according to an algorithm that begins with simple non-invasive therapies and progresses to invasive surgical therapies you never learn from your own experience. These are the reasons why we consider urodynamics to be an essential component in the armamentarium of the physician who treats patients with lower urinary tract symptoms. Why an atlas? For those with logical minds who like to lump things together categorize and classify an atlas might seem redundant. Why not show a few examples of this and that and be done with it? We believe that no two people are exactly alike that urodynamics are riddled with artifact and that human physiology is subject to the same
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