Urodynamic Science 2 (SPS323)

30 credits

Aim of this module

This module provides trainees with a specialised body of knowledge that is applied during specialist work based learning in Urodynamic Sciences. This rotation will enable trainees to perform a range of clinical diagnostic procedures undertaken to investigate disorders of the urinary system, interact with patients and demonstrate safe, patient-centred practice. Trainees will be expected to undertake a range of investigations, 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, explain procedures to patients and gain consent. Trainees will also develop and build their professional practice.

  1. Plan and perform, under appropriate practitioner direction, video urodynamics tests to identify vesico-ureteric reflux, trabeculation, diverticulae and different types of incontinence.
  2. Plan and perform ambulatory urodynamic monitoring to investigate patients referred for a range of situations, including indeterminate cystometry or unreproduced symptoms.
  3. Plan and perform urethral pressure profile testing, maintaining awareness of the test’s limitations.
  4. Interpret the data and produce high-quality reports and images with respect to video urodynamics, urethral pressure profiles and ambulatory urodynamic monitoring, being able to differentiate between artefact and physiological occurrence.
  5. Understand the requirements for appropriate support, routine maintenance and calibration procedures on equipment used in video urodynamics, urethral pressure profiles and ambulatory urodynamics.
Number Work-based learning outcome Title Knowledge
1 1,2,3

Control infection risks in accordance with departmental protocols.

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2 1,2,3

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

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3 1,2,3

Select suitable technology for video urodynamics, urethral pressure profile (UPP) and ambulatory urodynamics, choosing and adapting the appropriate diagnostic technique, patient position, machine settings and transducer for each patient.

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4 1,2,3

Set up equipment for video urodynamics, UPP and ambulatory urodynamics ready for use.

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5 1,2,3

Obtain a suitably completed request form, greet the patient and check patient identity.

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6 1,2,3

Explain video urodynamics, UPP and ambulatory urodynamics to the patient and address any questions they procedure, including the process after the procedure and how the patient will be informed of the results.

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7 1,2,3

Gain informed consent from patients referred for video urodynamics, UPP and ambulatory urodynamics investigation.

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8 1,2,3

Obtain a clinical history as appropriate from patients referred for video urodynamics, UPP and ambulatory urodynamics.

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9 1,2,3

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

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10 1,2,3

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

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11 1,2,3

Carry out each investigation (video urodynamics, UPP and ambulatory urodynamics) in patients presenting with previous surgery, neuropathy or lower urinary tract symptoms at a younger adult age.

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12 1,2,3

Safely remove the catheters.

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13 4

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

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14 4

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

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15 4

Produce a clear written report of the investigation.

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You must complete
5 Case-based discussion(s)
5 of the following DOPS / OCEs
Assessment Title Type
Set up video urodynamics equipment to national standards DOPS
Carry out videourodynamics to national standards choosing settings appropriate for patient and recording results DOPS
Set up ambulatory urodynamics equipment to national standards DOPS
Carry out ambulatory urodynamics to national standards choosing appropriate settings for patient and record results DOPS
Set up equipment for urethral pressure profile test to national standards DOPS
Carry out urethral pressure profile test to national standards and record results DOPS
Recognise and take account of any features or artefacts present in measurements DOPS
Interpret and report on urodynamics data with respect to reported symptoms DOPS
Maintain equipment maintenance record DOPS
Conduct an infection control assessment appropriate to a piece of equipment DOPS
Explain clearly the need for videourodynamic measurement and process for the test OCE
Explain clearly the need for ambulatory urodynamic measurement and process for the test OCE
Explain clearly the need for urethral pressure profile measurement and process for the test OCE
Communicate effectively with patient during test for understanding and repetition of symptoms OCE
reassurance and maintain awareness of patients experience 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 function of the lower urinary tract in children.
  2. Describe neurogenic bladder dysfunction and explain dysnergia between the bladder and bladder neck or distal sphincter and grades of vesico- ureteric reflux.
  3. Describe the pathophysiology of a range of conditions affecting the urinary tract and the appropriate choice of urodynamic investigation (including including ambulatory urodynamics), considering the findings from the history and clinical examination.
  4. Explain the effects of neurological conditions on male and female GI, sexual and reproductive function, and the potential impact on the patient.
  5. Appreciate the relative importance in the neurogenic bladder of risk to renal function and control of incontinence.
  6. Describe the principles of radiation protection and contrast medium usage applied to urodynamic science.
  7. Discuss and critically evaluate a range of equipment used in urodynamic science, including video-urodynamics.
  8. Interpret the results from video-urodynamics in a range of patients and make recommendations for possible treatment options and follow-up.

Indicative Content

Anatomy and physiology

  • Structure and function of the spinal cord
  • Pelvic floor musculature
  • Anal sphincter complex and their innervations
  • Sexual and reproductive function
  • Knowledge of gastrointestinal tract and likely associated dysfunction
  • Indications for leaving post-void residual

Neurophysiology

  • Neurological conditions in male and female GI
  • Neurophysiology of the urinary tract

Pathology

  • Spinal cord injury
  • Multiple sclerosis
  • Spina bifida
  • Stroke
  • Head injury
  • Parkinson’s disease
  • Myelomeningocele and posterior urethral valves
  • Bladder diverticula
  • Spinal shock
  • Autonomic dysreflexia
  • Post traumatic syringomyelia
  • Hydrocephalus

Pharmacology

  • Contrast medium
  • Use of prophylactic antibiotics
  • Medication potentially affecting the bladder
  • Use of antimuscarinics and botulinum toxin in neurological patients

Device design and technology

  • Video and ambulatory urodynamics
  • Ultrasound
  • Principles of radiation protection
  • Sterilisation protocols relating to solid-state transducers and air-filled catheters

Patient groups

  • Adult female and males
  • Paediatric urodynamics
  • Neurological patients