(1)
Functional Urology Unit, Casa Madre Fortunata Toniolo, Bologna, Italy
4.1 When Is Urodynamic Testing Indicated?
In the last few years, several societies (ICS, AUA, NICE, AUGS, Urinary Incontinence Treatment Network) have published recommendations regarding the use of urodynamics. These guidelines can be summarized as follows:
Urodynamics may be optional or even unnecessary when:
A conservative treatment is planned.
In patients with uncomplicated stress urinary incontinence.
In patients with neurogenic bladder at low risk of renal complications (multiple sclerosis).
Urodynamics is useful when:
The patient’s symptoms do not correlate with objective findings (complex symptoms).
Prior therapies have failed.
Urodynamics is strongly recommended:
In females with urinary incontinence or pelvic organ prolapse when an invasive procedure is planned
In men with voiding symptoms to assess if symptoms are due to bladder outlet obstruction or detrusor underactivity when TURP is planned
In patients with neurogenic bladder who will require long-term urologic management to establish a baseline
4.2 Which Testing Should Be Selected?
Urodynamics testing range in complexity and include:
Noninvasive evaluation
Invasive evaluation
In turn, invasive evaluation includes:
Conventional urodynamics
Ambulatory urodynamics
Some patients may not need the full spectrum of tests; in fact, some patients may not require urodynamic testing at all after the clinical evaluation is complete.
Table 4.1 indicates urodynamic testing currently available and function investigated, and Table 4.2 indicates acronyms of measured urodynamic parameters.
Table 4.1
List of urodynamic testing and function investigated
UDS testing | Function investigated |
|---|---|
Uroflowmetry | Voiding process |
Cystometry | Storage phase |
DLPP | Risk of upper tract deterioration |
VLPP | Urethral competence
Related posts: Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
Get Clinical Tree app for offline access
|
