Urodynamics

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A 47-year-old woman with stress leakage on coughing and a positive cough stress test asks whether she needs "the bladder pressure test" before a sling. The answer depends on whether stress incontinence is clinically demonstrated and on whether any of NICE's four indications for preoperative cystometry are present.^[1]

What urodynamics is

The ICS Good Urodynamic Practices and Terms 2016 updated the 2002 standard: it newly or more precisely defined more than 30 terms and set standards for the practice, quality control, interpretation and reporting of urodynamics, cystometry and pressure-flow analysis, with recommendations for pre-test information and patient preparation.^[2] The joint IUGA/ICS terminology report for female pelvic floor dysfunction contains more than 250 definitions and defines the six most common diagnoses.^[7]

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References16ShowHide

1. [1]National Institute for Health and Care Excellence Urinary incontinence and pelvic organ prolapse in women: management (NG123) — Recommendations NICE guideline NG123, 2019.Source
2. [2]Rosier PFWM, Schaefer W, Lose G, et al. International Continence Society Good Urodynamic Practices and Terms 2016: Urodynamics, uroflowmetry, cystometry, and pressure-flow study. Neurourology and urodynamics, 2017.PMID 27917521
3. [3]Nager CW, Brubaker L, Litman HJ, et al. A randomized trial of urodynamic testing before stress-incontinence surgery. The New England journal of medicine, 2012.PMID 22551104
4. [4]van Leijsen SAL, Kluivers KB, Mol BWJ, et al. Value of urodynamics before stress urinary incontinence surgery: a randomized controlled trial. Obstetrics and gynecology, 2013.PMID 23635736
5. [5]Abdel-Fattah M, Chapple C, Cooper D, et al. Invasive urodynamic investigations in the management of women with refractory overactive bladder symptoms (FUTURE) in the UK: a multicentre, superiority, parallel, open-label, randomised controlled trial. Lancet (London, England), 2025.PMID 40132616
6. [6]Abdel-Fattah M, Chapple C, Breeman S, et al. Invasive urodynamic investigations in the management of women with refractory overactive bladder symptoms: FUTURE, a superiority RCT and economic evaluation. Health technology assessment (Winchester, England), 2025.PMID 40620147
7. [7]Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourology and urodynamics, 2010.PMID 19941278
8. [8]Haylen BT, Yang V, Logan V Uroflowmetry: its current clinical utility for women. International urogynecology journal and pelvic floor dysfunction, 2008.PMID 18427706
9. [9]Abdel-Fattah M, Chapple C, Guerrero K, et al. Female Urgency, Trial of Urodynamics as Routine Evaluation (FUTURE study): a superiority randomised clinical trial to evaluate the effectiveness and cost-effectiveness of invasive urodynamic investigations in management of women with refractory overactive bladder symptoms. Trials, 2021.PMID 34702331
10. [10]Glass D, Lin FC, Khan AA, et al. Impact of preoperative urodynamics on women undergoing pelvic organ prolapse surgery. International urogynecology journal, 2020.PMID 31456030
11. [11]Rachaneni S, Latthe P Does preoperative urodynamics improve outcomes for women undergoing surgery for stress urinary incontinence? A systematic review and meta-analysis. BJOG : an international journal of obstetrics and gynaecology, 2015.PMID 25041381
12. [12]Bodmer NS, Wirth C, Birkhäuser V, et al. Randomised Controlled Trials Assessing the Clinical Value of Urodynamic Studies: A Systematic Review and Meta-analysis. European urology open science, 2022.PMID 36110903
13. [13]Norton PA, Nager CW, Brubaker L, et al. The cost of preoperative urodynamics: A secondary analysis of the ValUE trial. Neurourology and urodynamics, 2016.PMID 25327775
14. [14]Mengerink BB, Nelen WLDM, van Leijsen SAL, et al. De-implementation of urodynamics in The Netherlands after the VALUE/VUSIS-2 results: a nationwide survey. International urogynecology journal, 2018.PMID 29679158
15. [15]Irwin DE, Kopp ZS, Agatep B, et al. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU international, 2011.PMID 21231991
16. [16]Chai TC, Moalli PA, Richter HE, et al. Preoperative Urodynamic Parameters (Valsalva Leak Point Pressure and Maximum Urethral Closure Pressure), Urinary Collagen and Plasma Vitamin D Levels as Predictors of Mid Urethral Sling Surgery Outcome. The Journal of urology, 2016.PMID 27113967