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Cystocele (Fallen Bladder) Bethesda, MD: National Kidney and Urologic Diseases Information Clearinghouse. 2007. 2 p.

This fact sheet describes cystocele, a condition that occurs when the wall between a woman’s bladder and her vagina weakens and allows the bladder to droop into the vagina. This condition may cause discomfort and problems with emptying the bladder. A bladder that has dropped from its normal position may cause two kinds of problems: unwanted urine leakage and incomplete emptying of the bladder. Written in a question-and-answer format, the fact sheet reviews the causes of cystocele, diagnostic tests that may be used to confirm the presence of a cystocele, and treatment options, which range from no treatment to surgery. The fact sheet includes the contact details for three resource organizations through which readers can get more information and a description of the goals and activities of the National Kidney and Urologic Diseases Information Clearinghouse.

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Urinary Retention. Bethesda, MD: National Kidney and Urologic Diseases Information Clearinghouse. 2007. 8 p.

This fact sheet describes urinary retention, which is defined as the inability to empty the bladder. With acute urinary retention, one cannot urinate at all, even with a full bladder. Acute urinary retention is a medical emergency that requires prompt action. Chronic urinary retention may not seem life-threatening, but it can lead to serious problems and should receive attention from a health professional. Written in a question-and-answer format, the fact sheet reviews the physiology of the urinary tract; considers the causes of urinary retention, which include nerve disease, spinal cord injury, prostate enlargement, also known as benign prostatic hyperplasia (BPH), infection, surgery, medications, bladder stones, cystocele or rectocele, constipation, and urethral stricture; notes the symptoms of urinary retention; diagnostic approaches used to confirm urinary retention, including the patient history and physical examination, urine sample, bladder scan, cystoscopy, radiography and computer tomography (CT) scan, PSA blood test, prostate fluid sample, and urodynamic tests; reviews treatments, including catheterization, treatments to relieve prostate enlargement, and surgery; and notes the complications of urinary retention and its treatments, including urinary tract infections, bladder damage, chronic kidney disease, and incontinence and erectile function after prostate surgery. A final section briefly reviews current research programs in this area. The fact sheet includes the contact details for two resource organizations through which readers can get more information and a description of the goals and activities of the National Kidney and Urologic Diseases Information Clearinghouse. 1 figure.

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Videourodynamics. IN: Atlas of Urodynamics. 2nd ed. Williston, VT: Blackwell Publishing Inc. 2007. pp 62-68.

The purpose of urodynamic testing is to measure and record various physiological variables while the patient is experiencing those symptoms which make up the presenting complaint. Videourodynamics provides the synchronous measurement and display of urodynamic parameters with radiographic visualization of the lower urinary tract and is a precise diagnostic tool for evaluating disturbances of micturition. This chapter on videourodynamics is from an atlas of urodynamics that provides a comprehensive, detailed look at the indications, technology, and use of urodynamics in modern urologic practice. The chapter begins with a brief section describing how videourodynamics can be used and then presents case illustrations, accompanied by figures and black-and-white photographs of actual urodynamic tests. The authors also outline the technique and equipment used. Videourodynamics is used to evaluate overall bladder control; degree of cystocele and urethrocele at rest and with straining; the state of the bladder neck at rest and straining (closed, beaked, or open); the presence of vesicoureteral reflux, bladder or urethral diverticula or fistula; and the site of urethral obstruction. 4 figures. 6 references.

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Has My Bladder Fallen? An Introduction to Pelvic Organ Prolapse. Quality Care. 24(2): 4. 1st Quarter 2006.

This brief article, from a newsletter for people with urinary incontinence, introduces readers to the problem of pelvic organ prolapse (POP). In POP, also called cystocele, the pelvic organs (uterus, bladder, bowels) can move out of position because the walls and supports that should keep them in place have given way. This condition is particularly common in women who have delivered a child vaginally. The author reviews the symptoms, the different terminology that is used to describe different types of POP, how prolapse can be interrelated with urinary incontinence, and surgical and nonsurgical options for treating prolapse. Readers are encouraged to educate themselves and to work closely with their health care providers to find a solution for any pelvic organ prolapse symptoms.

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Urodynamically Defined Stress Urinary Incontinence and Bladder Outlet Obstruction Coexist in Women. Journal of Urology. 171(2): 757-761. February 2004.

The definition and significance of female bladder outlet obstruction (BOO) are poorly understood. This study identified patients with urodynamic evidence of BOO in a cohort of women with stress urinary incontinence (SUI). Of 104 eligible subjects, 19 (18.3 percent) had BOO. Maximum flow rate, mean flow rate, and voided volume were significantly less in the BOO group than in the unobstructed group. Detrusor pressure at maximum flow, maximum detrusor pressure, and post-void residual volume were significantly greater in the BOO group than in the unobstructed group. Etiologies (causes) of BOO identified in the 19 subjects included prior anti-incontinence or prolapse surgery in 6 patients, neurological conditions in 4 patients, cystocele in 2 patients, dysfunctional voiding in 3 patients, and idiopathic (unknown) in 5 patients. The authors conclude that SUI and BOO can coexist even in the absence of common causes of obstruction. Appended to the article are two commentaries. 2 tables. 12 references.

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