BHN Healthcare Blog

Urodynamic testing has the potential to provide health care professionals with much more detailed information on the health of their patient’s bladders, urethras, and their body’s ability to store and flush urine. Urodynamics, especially when used in rural health clinics, allows health care professionals to more accurately diagnose causes of urinary incontinence and other issues relating to the bladder and lower urinary system, making it a key service that needs to be integrated into RHC practices.

What Is Urodynamics?

Urodynamics along with urodynamic testing, in its simplest form, is the assessment of how the bladder, urethra, and associated sphincters do their job for storing and releasing urine from the body.

2020 and 2021 have shown that urodynamics continues to grow and find unique and novel applications for diagnosing health issues relating to the bladder, urethra, and more. Here we have outlined 4 of the most interesting studies of the past year in the world of urodynamics:

On January 20th of this year, Joe Biden was sworn in as the United States of America’s 46th president. Like any new leader of a country, this change in the White House meant many different things for various people, businesses, and entire industries.

The new administration is a tremendous shift from the previous one, changing the nation’s landscape across the board.

No more are these changes evident than in healthcare. Biden and his administration’s approach - even at first glance - is a totally different beast than former President Trump’s. With that said, how will this impact private practices across the US?

This blog will explore the above question and then delve into urology practices, specifically.

Disclaimer: I have not used the new system myself and relied upon colleagues who have for reviews. Additional information is from review of Laborie’s marketing materials.

Laborie’s new NXT Pro urodynamics (UDS) system has a variety of features designed to make the user operations simpler and more intuitive. In addition, technological enhancements allow automation of several aspects of the exam and Bluetooth connections to monitoring devices.

Reimbursement is always a hot topic in urologic care, especially with regards to specific procedures. While individual payors may vary with regards to what they pay for specific evaluation and management (E&M) and procedures (CPT codes), almost all reimbursement is ultimately driven by what rates Medicare will pay and/or how many Relative Value Units (RVU’s) Medicare will assign to a specific E&M or CPT code. This post will review reimbursement trends for urodynamics in 2020 (UDS).

Urodynamics (UDS) is a relatively safe office procedure; however, as with any invasive procedure or test, there are risks associated with performing UDS. A few simple steps can help avoid complications in the majority of patients. Most of the complications associated with UDS are related to urinary tract infections (UTI) and the majority of this blog will focus on that. Additional complications include pain, patient anxiety and injury from catheter placement.

UTI is the most common serious complication of UDS testing, though the frequency of this is difficult to quantify.¹ There are excellent guidelines on this from the University of Michigan¹ and the American Urologic Association (AUA) also offers guidance for the prevention of UTI’s associated with UDS.²

Recently, a large-scale study of men referred to urologists in England for difficulty urinating has published results (Lewis Eur Urol 2019). This trial, called UPSTREAM, recruited over 800 men for two dozen locations across England. In addition to the usual history, physical and baseline evaluation for the voiding issues, some men were randomized to undergoing a urodynamics test (UDS) and the authors have recently reported some of their data.

During a urodynamics study (UDS), there are a variety of pieces of data coming in to the urologist and technician performing the study. Information will be obtained that is both subjective and objective in nature and the question is, who do you believe? Do you believe yourself and the objective data you are reviewing? Or, do you believe what the patient is telling you during the study? This blog post will explore this in detail.

Providing an effective field service is one of the key responsibilities of medical device companies.

Traditionally, field service agents have been technical support staff with little to no background in medical sciences. Today, however, there is an increasing trend toward incorporating nursing staff, particularly nurse educators, in medical device field service.

Any industry thrives on customer satisfaction, and this applies equally to medical device companies. For medical device companies, customers are typically healthcare professionals who are fully satisfied only when they are able to use a device correctly and to its maximum efficacy, and can summon support to troubleshoot problems as soon as they crop up. Hence, the need for a reliable and readily available field service that can handle problems related to medical devices quickly.

What is expected from a traditional field service?

Field service is required after the sale of medical devices and field staff from the medical device company visit customer premises—usually a hospital or clinic—for this purpose. The general expectations from a field service are:

Urodynamics (UDS) testing is usually performed in conjunction with a slew of other urologic tests and functions in concert with other diagnostics. This blog post will explore other common tests used in patients who will be having UDS testing and explains the indications and data that come from those other assessments.

            All patients who have UDS will undergo a comprehensive history, physical and laboratory testing. The history will focus on the specific urologic complaints the patient has, but also bowel issues, neurologic disorders and whatever medications the patient is on as well. Surgical history, especially related to urinary tract and anti-incontinence surgery is critical as is diet information. Lab testing will include a urinalysis to search for blood or infection, urine culture if infection is suspected, and many patients will have serum lab testing to assess kidney function.