Putting It All Together: Practical Advice on Clinical Urodynamics

  • Julian WanEmail author
  • John T. Stoffel


Urodynamic testing can be applied successfully to the real world of everyday clinical practice. The tests are ideally simulations of the clinical question posed by the patient’s condition. There is a reciprocal relationship between the tests and data which can be gathered. The simpler tests, uroflow and post void residual, are easy to perform but offer limited information. The more complex tests, cystometrogram with fluoroscopy and electromyography, offer a more accurate simulation and allow a better recreation of the clinical scenario but are not as easy to perform. Practitioners must always keep clinical context in mind; urodynamic findings by themselves are not pathognomonic. If a provider is not going to be physically present at the tests, the staff members who are actually doing the studies must share a common understanding of the methods and goals with the urologist who is interpreting the results. Level of testing should match with complexity of the clinical question being asked.


Practical advice Fluoroscopy Urodynamic laboratory Real world use Tailored urodynamics Complex cystometrogram 


  1. 1.
    Katz MA. Hyperglycemia-induced hyponatremia calculation of expected serum sodium depression. NEJM. 1973;289(16):843–4.CrossRefPubMedGoogle Scholar
  2. 2.
    Hillier TA, Abbott RD, Barrett EJ. Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med. 1999;106(4):399–403.CrossRefPubMedGoogle Scholar
  3. 3.
    BladderScan®, Verathon Inc., Bothell, WA, USAGoogle Scholar
  4. 4.
    Daan NM, Schweitzer KM, van der Vaart CH. Associations between subjective bladder symptoms and objective parameters on bladder diary and filling cystometry. Int Urogynecol J. 2012;23(11):1619–24.PubMedCentralCrossRefPubMedGoogle Scholar
  5. 5.
    van Waalwijk van Doorn ES, Meier AH, Ambergen AW, Janknegt RA. Ambulatory urodynamics: extramural testing of the lower and upper urinary tract by Holter monitoring of cystometrogram, uroflowmetry, and renal pelvic pressures. Urol Clin North Am. 1996;23:345–71.CrossRefPubMedGoogle Scholar
  6. 6.
    Swithinbank LV, James M, Shepherd A, Abrams P. Role of ambulatory urodynamics monitoring in clinical urological practice. Neurourol Urodyn. 1999;20:249–57.Google Scholar
  7. 7.
  8. 8.
    State of Michigan Department of Licensing and Regulatory Affairs within a Radiation Safety Section websit. 2014.,4601,7-154-61256_11407_35791---,00.html. Retrieved 1 Sept 2014.
  9. 9.
    McGuire EJ, Woodside JR, Borden TA, Weiss RM. Prognostic value of urodynamic testing in myelodysplastic patients. J Urol. 1981;126(2):205–9.PubMedGoogle Scholar
  10. 10.
    Ghoniem GM, Bloom DA, McGuire EJ, Stewart KL. Bladder compliance in meningomyelocele children. J Urol. 1989;141:1404–6.PubMedGoogle Scholar
  11. 11.
    Gormley EA, Bloom DA, McGuire EJ, Ritchey ML. Pubovaginal slings for the management of urinary incontinence in female adolescents. J Urol. 1994;152:822–5.PubMedGoogle Scholar
  12. 12.
    Roth DR, Vyas PR, Kroovand RL, Perlmutter AD. Urinary tract deterioration associated with the artificial urinary sphincter. J Urol. 1986;135(3):528–30.PubMedGoogle Scholar
  13. 13.
    Wan J, McGuire EJ, Bloom DA, Ritchey ML. The treatment of urinary incontinence in children using glutaraldehyde cross-linked collagen. J Urol. 1992;148(1):127–30.PubMedGoogle Scholar
  14. 14.
    McGuire EJ, Cespedes RD, O’Connell HE. Leak-point pressures. Urol Clin North Am. 1996;23(2):253–62.CrossRefPubMedGoogle Scholar
  15. 15.
    Schafer W, Abrams P, Liao L, Anders M, Pesce F, Spangbert A, Sterling AM, Zinner NR, van Kerrebroeck P. Good urodynamic practices: uroflowmetry, filling cystometry and pressure-flow studies. Neurourol Urodyn. 2002;21:261–74.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Division of Pediatric Urology, Department of UrologyC.S. Mott Children’s and Von Voigtlander Women’s HospitalAnn ArborUSA
  2. 2.Division of Neurourology and Pelvic Reconstructive Surgery, Department of UrologyUniversity of Michigan Medical CenterAnn ArborUSA

Personalised recommendations