Urodynamic Assessment of Overactive Bladder

Abstract

Urodynamic studies (UDS) generate information about bladder function that, currently, no other testing can provide. Though clearly not necessary to evaluate all lower urinary tract symptoms (LUTS), UDS can be useful when confronted with situations in which the normal noninvasive parameters used to assess LUTS, such as questionnaires, flow rates, and postvoid residual testing, are not helpful. There are a few keys to developing a successful urodynamic laboratory and to conducting studies that can be readily interpreted and utilized for clinical planning. Perhaps the foremost among these are the ability to re-create the LUTS in question during the UDS and training capable technicians who understand the equipment and the patients so that they are able to accomplish this task. Having the clinician present or readily available during the study is essential to generating interpretable data. A poorly conducted UDS test will tell you nothing about the symptom or problem in question, may only serve to further muddy the clinical picture, and may dissuade the patient from further care. On the other hand, a properly conducted test will give insight into the pathophysiology underlying the clinical condition, may provide some type of assessment of risk to the patient of leaving the condition untreated, and will clearly help guide management.