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These guidelines provide benchmarks for the performance of urodynamic equipment, and have been developed by the International Continence Society to assist purchasing decisions, design requirements, and performance checks. The guidelines suggest ranges of specification for uroflowmetry, volume, pressure, and EMG measurement, along with recommendations for user interfaces and performance tests. Factors affecting measurement relating to the different technologies used are also described. Summary tables of essential and desirable features are included for ease of reference. It is emphasized that these guidelines can only contribute to good urodynamics if equipment is used properly, in accordance with good practice.

aplastic anaemia is characterised by anaemia, leucopenia, and thrombocytopenia. The defect is cellular with an increased tendency to infection and bleeding.4 Although prejudicial to the success of skin grafting, it is not a contraindication provided deficiencies are corrected perioperatively, haemostasis is achieved before grafting, and the formation of haematoma is avoided afterwards.Each of these children had a chronic cutaneous manifestation ofa haematological or immunodeficiency disease. Healing was assumed to be abnormal because of a defect in either humoral or cellular defence mechanisms. This assumption delayed referral for surgery by some months in each case, but debridement followed by split skin grafting produced rapid healing.We thank Professor J M Chessels and Dr D A Atherton for their permission to report on patients under their care. Case 2-A 16 year old army recruit was admitted on the same date with a four day history of malaise, vomiting, sore throat, blistering around the mouth, dry cough, and pleuritic pain on the left side. He had also developed central abdominal pain. On examination he had a fever, with a temperature of 39 2°C. Respiratory examination disclosed signs of left basal consolidation, which was confirmed by chest radiography, and abdominal examination showed epigastric and umbilical tenderness and tenderness in the right iliac fossa, with rebound tenderness. He was treated with penicillin and erythromycin, and his temperature settled within 24 hours. The tenderness in his right iliac fossa persisted for three days; the presumptive diagnosis was mesenteric adenitis. He was discharged after one week.

Aims To review the recommendations on basic urodynamic testing in the International Continence Society (ICS) standardization documents, specifying key recommendations for delivery and interpretation in clinical practice. Methods Fundamental expectations described in the ICS standards on good urodynamic practices, urodynamic equipment, and terminology for lower urinary tract (LUT) function were identified and summarized. Results The ICS standard urodynamic protocol includes clinical history, including symptom and bother score(s), examination, 3‐day voiding chart/diary, representative uroflowmetry with post‐void residual, and cystometry with pressure‐flow study (PFS). Liquid filled catheters are connected to pressure transducers at the same vertical pressure as the patient's pubic symphysis, taking atmospheric pressure as the zero value. Urodynamic testing is done to answer specific therapy‐driven questions for treatment selection; provocations are applied to give the best chance of reproducing the problem during the test. Quality of recording is monitored throughout, and remedial steps taken for any technical issues occurring during testing. Labels are applied during the test to document events, such as patient‐reported sensation, provocation tests, and permission to void. After the test, the pressure and flow traces are scrutinized to ensure artefacts do not confound the findings. An ICS standard urodynamic report details the key aspects, reporting clinical observations, technical, and quality issues. Urodynamic services must maintain and calibrate equipment according to manufacturer stipulations. Conclusions The review provides a succinct summary of practice expectations for a urodynamic unit offering cystometry and pressure flow studies (PFS) to an appropriate standard.

Methods: During a three day meeting a group of specialists discussed compliance, what it represents, how it can be measured and if it is clinically relevant.Results: Bladder compliance is the result of a mathematical calculation of volume responsible for 1 cm H2O pressure rise measured during a cystometric filling. It gives an indication on how the different mechanisms in the bladder wall react on stretching. There is a need of standardisation of measurement and suggestions for this are given in the text. Pitfalls are described and how to avoid them. There is a wide range of compliance values in healthy volunteers and groups of patients. Poor compliance needs to be defined better as it can have significant clinical consequences. Prevention and treatment are discussed.Conclusion: If compliance is correctly measured and interpreted, it has importance in urodynamic testing and gives information relevant for clinical management.

All common or important urodynamic pressure events have been included in this study and descriptions of the events have been included in one article for the first time.

Characterizing the integrative physiology of the bladder requires whole organ preparations. The purpose of this study was to validate an isolated large animal (pig) bladder preparation, through arterial and intravesical drug administration, intravesical pressure recording, and filming of surface micromotions. Female pig bladders were obtained from the local abattoir and arterially perfused in vitro. Arterial and intravesical pressures were recorded at varying volumes. Bladder viability was assessed histologically and by monitoring inflow and outflow pH. Arterial drug administration employed boluses introduced into the perfusate. Intravesical administration involved slow instillation and a prolonged dwell-time. Surface micromotions were recorded by filming the separation of surface markers concurrently with intravesical pressure measurement. Adequate perfusion to all bladder layers was achieved for up to 8 h; there was no structural deterioration nor alteration in inflow and effluent perfusate pH. Arterial drug administration (carbachol and potassium chloride) showed consistent dose-dependent responses. Localized movements (micromotions) occurred over the bladder surface, with variable correlation with fluctuations of intravesical pressure. The isolated pig bladder is a valid approach to study integrative bladder physiology. It remains viable when perfused in vitro, responds to different routes of drug administration and provides a model to correlate movements of the bladder wall directly to variation of intravesical pressure.

This study shows that AFCs and WFCs cannot be assumed to register equal values of pressure. It has further shown that even when the p readings are compared with their value at the start of a test, a divergence of values of up to 10 cmH O remains. If AFCs are used, care must be taken to compensate for any p variations that occur during patient movement. Before AFCs are adopted, new normal values for resting pressures need to be developed to allow good quality AFC pressure readings to be made. Neurourol. Urodynam. 35:926-933, 2016. © 2015 Wiley Periodicals, Inc.