Who Needs Urodynamics?

Abstract

Multichannel urodynamic evaluation of urinary incontinence involves the recording of urethrocystometry, sphincter EMG, urethral closure pressure profiles and voiding pressure studies. Integrating these tests and performing them at various states of bladder fullness as well as in different positions can allow the urodynamicist to obtain a great deal of useful information. However, this testing is costly and time consuming. Therefore, it is not appropriate for every patient who suffers from lower urinary tract dysfunction to undergo multichannel urodynamics. Various laboratories across the country have their exact criteria for who needs urodynamics and who does not. It is safe to say that most researchers would enjoy the opportunity to study all their patients if possible. Where to draw the line between who undergoes multichannel studies and who undergoes single channel standing cystometry, stress testing and other simple clinical tests is difficult. The performance of EMG testing with voiding pressure studies is essential in the patient who has urinary retention. However, it also provides useful information in those patients about to undergo incontinence surgery.