Combined video/pressure/flow cystourethrography in female patients with voiding disturbances.

The urodynamic investigation of 152 female patients with symptoms of recurrent cystitis by synchronous video/pressure/flow cystourethrography is presented. The results fall into the following groups: (1) Normal: In 77 patients, no abnormality was found. (2) Bladder outflow obstruction: In 52 patients increased resistance to micturition was demonstrated at the level of the external sphincter. Levels of bladder pressure, flow rate, calculated urethral resistance, and cystographic appearance allow the degree of obstruction to be assessed and the urodynamic effect of treatment by dilation or urethrotomy to be appreciated. (3) Reflux: In 17 patients, reflux was demonstrated, 14 of whom showed no evidence of outflow obstruction. Postoperative assessment of reimplantation procedures are briefly discussed. (4) Systolic and unstable bladders: Six patients were in this group; the manifestations of instability are discussed together with the concept of sensory and motor urgency.