Samir S. Taneja, MD, Consulting Editor

One could argue that the tremendous advances in the pharmacologic management of bladder dysfunction have been made possible by the data provided through urodynamic testing. By providing a metric for assessing therapeutic response, efficacy could be better assessed and titrated. In a similar manner, surgical therapy has been refined in patients with obstructive urinary dysfunction and in those with incontinence. Urodynamics have not only provided a measure of success for therapy, but, more importantly, the testing has allowed strict indications for surgical intervention to be defined.

The use of urodynamics in clinical practice has gone from a rarely used tool to one that is, perhaps, overutilized due to wide availability and financial incentive. The testing has clear indications, and its use should be among those patients in whom management would clearly be influenced by outcome. Instructing urologists in the clear indications for and practice of urodynamics will be a necessary challenge for our field in the emerging era of health care reform. As such, this issue of Urologic Clinics of North America devoted to urodynamics is extremely timely.

The practice of urodynamics is constantly evolving. In this issue, I have asked my colleagues, Drs Benjamin Brucker and Victor Nitti, to provide us with an update of urodynamic testing, including indications, interpretation, and the impact of outcome on clinical management in common disorders. In doing so, they commissioned a comprehensive group of articles from our field’s leading experts, encompassing many of the common scenarios in which urologists are asked to assess voiding dysfunction. I am deeply indebted to Drs Brucker and Nitti, and the authors of these articles, who have provided a wonderful perspective on clinical management. Given the considerable impact of voiding dysfunction on the average urology practice, I have no doubt the articles will serve as a valuable resource for our readers.