Objective      To review and analyze the diagnostic characteristics of urinary voiding dysfunction in patients undergoing imaging urodynamic examination

and to explore the advantage of imaging urodynamic diagnosis in complicated voiding dysfunction.       Methods      Data were collected from 239 patients (165 males and 74 females)

who underwent imaging urodynamic examination due to lower urinary tract voiding dysfunction in our department from January 2014 to July 2014. All patients were examined by the same urodynamic clinician according to the Urodynamic Operations Guide of the Chinese Urological Association (2010 edition). The diagnostic characteristics of neurogenic or non-neurogenic bladder urodynamics and lower urinary tract imaging were analyzed

and the characteristics of typical complicated voiding dysfunction and the morphological changes of the ureter

bladder and urethra were observed.       Results      Of 239 patients with nervous disease and voiding dysfunction

32 patients (13.39%) with neurogenic bladder were diagnosed by imaging urodynamics

and there were 8 patients with detrusor hyperreflexia and urge incontinence

3 with cerebrovascular accident

1 with Parkinson’s disease

2 with Alzheimer’s disease

1 with sacral spina bifida and 1 with radical hysterectomy. Twenty-four patients were diagnosed with detrusor weakness and urinary retention

and among them

there were 16 patients with diabetes

2 with acute infectious polyneuritis

2 with alcoholism

1 with drug abuse

and 3 with falling-caused back or sacral spinal cord injury. Also

urodynamic images indicated 1 patient with unilateral ureteral reflux

7 with bilateral ureteral reflux

2 with detrusor-bladder neck dyssynergia and 3 with detrusor-external sphincter dyssynergia. Of 203 patients (84.94%) diagnosed with non-neurogenic bladder by imaging urodynamics

there were 131 patients with bladder outlet obstruction

41 with pressure urinary incontinence

11 with simple detrusor overactivity

10 with weak detrusor contractility

and 10 with acontractile detrusor. There were 76 patients with bladder neck completely opened after voiding

129 patients with bladder neck partially opened

and 34 patients without bladder neck opened. In addition

the function of bladder and urethral was diagnosed as normal in 4 patients (1.67%).       Conclusion      Imaging urodynamic examination can help the clinicians to improve the diagnosis of detrusor-external urethral sphincter dyssynergia

detrusor-bladder neck dyssynergia

vesicoureteral reflux

and leak point pressure in patients with neurogenic bladder

and improve the diagnosis of the shape changes of bladder and urethra

urethral obstruction site and any foreign bodies in patients with non-neurogenic bladder.