Urology & Urogynecology > Education and Reference

This manual is intended to provide a basic introduction to the practice of Urodynamics. It is not intended to act as a definitive text, but we hope that it will provide enough information to prove that there is a tremendous amount of knowledge that must be refreshed or acquired in order to perform these procedures at an optimum level.

"Urodynamics is the dynamic study of the transport, storage and evacuation of urine by the urinary tract.”             - Victor W Nitti & Andrew J Combs

The International Continence Society (ICS) makes recommendations on terminology, testing parameters and good clinical practices for Urodynamic procedures. Their website is: www.icsoffice.org

In 2002 the ICS published a paper that defines “Good Urodynamic Practices”, specifying that the goal of urodynamics is to answer ‘urodynamic’ questions that are derived from a careful history, physical exam and standard urological investigations(1)

Urodynamic questions about bladder function during storage include:

1. Does the patient experience normal sensation of filling?
2. Is there evidence of detrusor over activity?
3. Is bladder compliance normal?
4. Is bladder capacity normal?
5. Is the outlet competent or incompetent?
6. ?????

Urodynamic questions about bladder function during emptying include:

1. Is voiding achieved by a voluntarily initiated, continuous detrusor contraction?
2. Does the bladder empty completely within a normal time span?
3. Is there evidence of outlet obstruction?
4. Is there evidence of neurologic dysfunction?
5. ?????

Remember, in order to do “good” urodynamics, you must know enough about the patient to know what the question is! The experienced urodynamicist adds questions based on the patient’s history.

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