Lower urinary tract dysfunction and its associated symptoms can be a significant burden to those who are affected. Whether it be lower urinary tract symptoms or upper tract consequences, there can be a tremendous negative impact of health-related quality of life in both men and women. Urodynamics, by studying how the lower urinary tract stores and empties, can be a critical tool in the management of patients, but should not be used indiscriminately. In the evaluation of patients with lower urinary tract dysfunction and lower urinary tract symptoms, clinicians should ask two critical questions: When are urodynamics helpful? and how will the information obtained influence patient management?
Although these two questions are straightforward, the answers can be extremely complex. This complexity can cause confusion in many people’s minds about the role of urodynamics in clinical practice. The urodynamic study must be done in an appropriately selected situation with a specific question in mind; it must be a well-executed high-quality study, and the results must be interpreted carefully in the appropriate clinical context.
As guest editors for this issue of Urologic Clinics of North America , it was our goal to provide readers with some of the tools that they will need to understand the subtle nuances of this field. The issue starts with the most up-to-date guidelines and practices and then takes the reader through some of the most common conditions that may require urodynamic investigation. After reading this issue cover to cover (or savoring each gem of an article), we have no doubt it will find a home on the office shelf next to the urodynamic unit user manual and be referenced often. It will help teach the less experienced urodynamicist and will update the more experienced with the latest clinical evidence. There are situations where urodynamics can have tremendous value, and these are highlighted in the following pages. But, just as importantly, there are limitations and shortcomings of these interactive studies that are also appropriately acknowledged.
The authors of these of articles include some of the brightest stars in our field. You will quickly understand, as you read their work, why we hand-selected each and every author. We are grateful that they agreed to work with us to provide this critically important review of urodynamics.