Urodynamic Studies in Adults
Publication Date: December 1, 2012
Last Updated: March 14, 2022
Stress Urinary Incontinence (SUI)/Prolapse
Clinicians who are making the diagnosis of urodynamic stress incontinence should assess urethral function. (Recommendation, C)
322809
Surgeons considering invasive therapy in patients with SUI should assess PVR urine volume. (Clinical Principle / Expert Opinion, )
322809
Clinicians may perform multichannel UDS in patients with both symptoms and physical findings of SUI who are considering invasive, potentially morbid, or irreversible treatments. (Option, C)
322809
Clinicians should perform repeat stress testing with the urethral catheter removed in patients suspected of having SUI who do not demonstrate this finding with the catheter in place during urodynamic testing. (Recommendation, C)
322809
In women with high-grade POP but without the symptom of SUI, clinicians should perform stress testing with reduction of the prolapse. Multichannel UDS with prolapse reduction may be used to assess for occult stress incontinence and detrusor dysfunction in these women with associated LUTS. (Option, C)
322809
Overactive Bladder (OAB), Urgency Urinary Incontinence, Mixed Incontinence
Clinicians may perform multichannel filling cystometry when it is important to determine if altered compliance, detrusor overactivity (DO), or other urodynamic abnormalities are present (or not) in patients with urgency incontinence in whom invasive, potentially morbid, or irreversible treatments are considered. (Option, C)
322809
Clinicians may perform PFS in patients with urgency incontinence after bladder outlet procedures to evaluate for BOO. (Clinical Principle / Expert Opinion, )
322809
Clinicians should counsel patients with urgency incontinence and mixed incontinence that the absence of DO on a single urodynamic study does not exclude it as a causative agent for their symptoms. (Clinical Principle / Expert Opinion, )
322809
Neurogenic Bladder
Clinicians should perform PVR assessment, either as part of complete urodynamic study or separately, during the initial urological evaluation of patients with relevant neurological conditions (e.g., spinal cord injury, myelomeningocele) and as part of ongoing follow-up when appropriate. (Standard, B)
322809
Clinicians should perform a complex CMG during initial urological evaluation of patients with relevant neurological conditions with or without symptoms and as part of ongoing follow-up when appropriate. In patients with other neurologic diseases, physicians may consider CMG as an option in the urological evaluation of patients with LUTS. (Recommendation, C)
322809
Clinicians should perform pressure flow analysis in patients with relevant neurologic disease with or without symptoms or in patients with other neurologic disease and elevated PVR or urinary symptoms. (Recommendation, C)
322809
When available, clinicians may perform fluoroscopy at the time of urodynamics (VUDS) in patients with relevant neurologic disease at risk for NGB or in patients with other neurologic disease and elevated PVR or urinary symptoms. (Recommendation, C)
322809
Clinicians should perform EMG in combination with CMG with or without PFS in patients with relevant neurologic disease at risk for NGB or in patients with other neurologic disease and elevated PVR or urinary symptoms. (Recommendation, C)
322809
Lower Urinary Tract Symptoms
Clinicians may perform PVR in patients with LUTS as a safety measure to rule out significant urinary retention both initially and during follow-up. (Clinical Principle / Expert Opinion, )
322809
Uroflow may be used by clinicians in the initial and ongoing evaluation of male patients with LUTS that suggest an abnormality of voiding/ emptying. (Recommendation, C)
322809
Clinicians may perform multi-channel filling cystometry when it is important to determine if DO or other abnormalities of bladder filling/urine storage are present in patients with LUTS, particularly when invasive, potentially morbid, or irreversible treatments are considered. (Clinical Principle / Expert Opinion, )
322809
Clinicians should perform PFS in men when it is important to determine if urodynamic obstruction is present in men with LUTS, particularly when invasive, potentially morbid, or irreversible treatments are considered. (Standard, B)
322809
Clinicians may perform PFS in women when it is important to determine if obstruction is present. (Recommendation, C)
322809
Clinicians may perform VUDS in properly selected patients to localize the level of obstruction, particularly for diagnosing primary bladder neck obstruction (PBNO). (Clinical Principle / Expert Opinion, )
322809
Recommendation Grading
Disclaimer
Overview
Title
Urodynamic Studies in Adults
Authoring Organizations
American Urological Association
Society of Urodynamics Female Pelvic Medicine & Urogenital Reconstruction
Publication Month/Year
December 1, 2012
Last Updated Month/Year
June 22, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
Assist clinicians in the appropriate selection of urodynamic tests, following an evaluation and symptom characterization.
Inclusion Criteria
Female, Male, Adult
Health Care Settings
Ambulatory, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Counseling, Diagnosis, Management
Diseases/Conditions (MeSH)
D014563 - Urodynamics, D059411 - Lower Urinary Tract Symptoms
Keywords
Urinary Incontinence, urodynamics, lower urinary tract symptoms, pelvic organ prolapse