Basic Urodynamics and Fundamental Issues

Urodynamics has two basic aims: to reproduce the patient's symptomatic complaints while making key observations, and provide a pathophysiological explanation by correlating the patient's symptoms with the urodynamic findings. Urodynamics in modern practice gives greater insight into each patient's lower urinary tract dysfunction (LUTD) and hence helps advise patients on potential benefit and risks for intervention, to support their expectations of informed decision-making. Good urodynamics is carried out by making pressure measurements relative to atmospheric pressure. The following symptoms should mandate a more careful neurological assessment in the urodynamic clinic: enuresis, voiding dysregulation, involuntary voiding, and evidence of LUT muscle weakness. The urodynamic community often fails to meet the expectations of the International Continence Society standards. During video-urodynamics, fluoroscopic screening can provide evidence of urethral leakage and will be sufficient for a diagnosis of urodynamic stress incontinence.