What kind of patients need urodynamic testing?

  Urodynamics is a specific test with a wide range of applications, but not every patient needs this complex test, not to mention that it is an invasive test.  The conditions that most require urodynamic testing are: urinary incontinence, bladder outlet obstruction, neurogenic bladder, urinary dysfunction in children and urinary incontinence.  To name a few, for example, female patients with stress urinary incontinence who require surgery; urinary incontinence may occur after radical prostatectomy or electrodesiccation, and urodynamic testing should be performed to determine the presence of an unstable bladder, hypo-compliant bladder or external sphincter injury.  Symptoms of bladder outlet obstruction, such as dyspareunia and thinning of the urinary line, can be caused by obstruction due to prostatic hypertrophy, reduced contraction of the bladder forcing muscles or inadequate sphincter relaxation, and urodynamic testing must be performed to differentiate.  Patients with neurogenic bladder should undergo urodynamic testing to clarify the nature of the forceps and sphincter lesions in order to determine treatment and understand prognosis. In patients with spinal cord injury who have spinal shock and no reflexes in the detrusor muscle, urodynamic review must be performed after the reflexes are restored.  Children with simple enuresis with daytime urgency, urge incontinence, recurrent urinary tract infection, vesicoureteral reflux, or upper urinary tract dilatation need to be screened with noninvasive uroflowmetry and electromyography, and if necessary, urodynamic testing for further clarification. However, invasive tests are difficult to perform in children, and human factors and the child’s lack of cooperation make interpretation of the results difficult and the tests unsatisfactory. The most common urodynamic abnormality in children with enuresis is involuntary contractile activity of the detrusor muscle. Pediatric patients can go to a children’s hospital, or a hospital with a pediatric department, and inquire beforehand.