Urodynamic Science 1 (SPS321)

10 credits

Aim of this module

This module provides trainees with the knowledge that underpins the specialist module in Urodynamic Science and gives these trainees the tools to undertake project based learning in the workplace. This rotation will enable trainees to perform a range of clinical diagnostic investigations undertaken within Urodynamic Science, interact with patients and demonstrate safe, patient-centred practice. Trainees will be expected to undertake a range of routine urodynamic investigations, and build practical skills in setting up and carrying out first-line maintenance of the equipment used. They will be able to produce reports, interpret results and explain procedures to patients, gain consent and develop and build their professional practice.

  1. Perform safe urethral catheterisation.
  2. Perform safe insertion of rectal catheters.
  3. Perform flowmetry, residual urine assessment by ultrasound, and filling and voiding cystometry in patients presenting with a range of conditions, for example urinary retention, urgency and stress incontinence.
  4. Interpret the data and produce high-quality reports with respect to flowmetry, residual urine assessment by ultrasound, and filling and voiding cystometry.
Number Work-based learning outcome Title Knowledge
1 1,2,3

Control infection risks in accordance with departmental protocols.

View
2 1,2,3

Minimise risks and hazards in compliance with health and safety policies.

View
3 1,2,3

Select suitable technology for each type of investigation, choosing and adapting the appropriate diagnostic technique, patient position, machine settings and transducer for each patient.

View
4 1,2,3

Set up equipment ready for use for each type of investigation.

View
5 1,2,3

Obtain a suitably completed request form, greet the patient, check patient identity and ensure that the patient’s identity is confirmed as correct and fully identified on each type of recording system.

View
6 1,2,3

Explain each type of procedure to the patient and address any questions they may have relating to the procedure, including the process after the procedure and how the patient will be informed of the results.

View
7 1,2,3

Gain informed consent for each type of investigation.

View
8 1,2,3

Obtain a clinical history as appropriate for each type of investigation.

View
9 1,2,3

Treat patients in a way that respects their dignity, rights, privacy and confidentiality.

View
10 1,2,3

Take appropriate action to respond to the specific needs of the patient, as defined by department protocol for each type of investigation.

View
11 1,2,3

Carry out each type of investigation.

View
12 1,2,3

Safely remove the catheters.

View
13 3

Review the results from each type of investigation, taking into account artefacts, necessary adjustments of values and planned/unplanned events occurring during the test.

View
14 4

Compare the values/traces obtained with the normal range/values related to each procedure.

View
15 4

Produce a clear written report of each type of investigation.

View
You must complete
3 Case-based discussion(s)
2 of the following DOPS / OCEs
Assessment Title Type
Perform safe urethral catheterisation DOPS
Perform safe insertion of rectal catheters DOPS
Set up flowmetry equipment, give patient instruction and record results DOPS
Set up cystometry equipment DOPS
Measure volume of residual urine using ultrasound DOPS
Carry out filling cystometry to national standards, choosing settings appropriate for patient DOPS
Carry out voiding cystometry to national standards at appropriate point DOPS
Recognise and take account of any artefacts present in measurements DOPS
Interpret and report on flowmetry and residual volume data with respect to reported symptoms DOPS
Interpret and report on filling and voiding data with respect to reported symptoms DOPS
Conduct an infection control assessment appropriate to a piece of equipment DOPS
Explain function of measurement catheters and insertion process OCE
Check patient ID and obtain verbal informed consent for catheterisation OCE
Take accurate and appropriate clinical history OCE
Provide reassurance and maintain awareness of patients experience OCE
Give clear patient instruction for flowmetry test OCE
Give clear patient instruction for residual urine measurement OCE
Take accurate and appropriate clinical history and take informed consent for a procedure OCE
Communicate effectively with patient for understanding and repetition of symptoms during urodynamics OCE
Clearly communicate post test instructions for the patient OCE
Explain procedure and the risks and benefits with respect to the patients comorbidities and medication to the investigation to obtain written and informed consent. OCE

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning Outcomes

  1. Describe the anatomy and physiology of the lower urinary tract system, including bladder neck anatomy, function and descent, and apply knowledge to the pathophysiology, investigation and treatment of patients referred to a Urodynamic Science service.
  2. Describe the autonomic nervous system, concepts of neuromodulation, and neurotransmitters in relation to the lower urinary tract.
  3. Describe the pathophysiology and effect of pelvic organ prolapse and urological disorders and the appropriate choice of investigation, considering the findings from the history and clinical examination.
  4. Explain the indications, contraindications, side effects and mode of action of medications potentially affecting the bladder.
  5. Explain and justify the principles of safe working practice, infection control and allergies.
  6. Describe and critically assess a range of techniques and instrumentation used in the investigation of the lower urinary tract, including flowmeters and cystometry.
  7. Explain and justify the rationale and procedures for the investigation of lower urinary tract symptoms in a broad patient range, e.g. paediatric, adult, elderly, spinal injury and other neurological conditions.
  8. Discuss and critically evaluate a range of different tests and equipment technology and design.

Indicative Content

Anatomy and physiology

  • Structure and function of the bladder neck
  • Sphincter mechanism
  • Bladder contours
  • Hormones in relation to urinary tract
  • Congenital abnormalities

Neurophysiology

  • Autonomic nervous system and neurotransmitters
  • Neuromodulation; sacral nerve and posterior tibial nerve stimulation
  • Regulation of micturition reflex

Pathophysiology including pelvic organ prolapse, bladder outlet obstruction and anatomical anomalies

  • Risk factors
  • Pathophysiology, including:
    • detrusor sphincter dyssynergia
    • neurogenic detrusor overactivity
    • spinal injury
    • bladder diverticula
    • allergy
    • encopresis and constipation as associated conditions
    • organ prolapse
    • outlet obstruction
    • cancer
    • multiple sclerosis
    • stroke
    • dementia

Pharmacology

  • Medications potentially affecting the bladder
  • The use of antibiotic prophylaxis
  • Botulinum neurotoxin
  • Antimuscarinics
  • Serotonin and noradrenalin reuptake inhibitors
  • Antidepressants
  • Antihypertensives
  • Female sex hormones