Are Urodynamic Studies a Core or Ancillary Urologic Procedure?

Posted by Dr. Peter Steinberg on May 16, 2019 7:56:15 PM
In any urology practice, critical questions related to what services to offer, who will provide them and where the services will be performed are the foundation of practice management. When establishing or managing a practice, one decision you must make is whether urodynamics (UDS) is a foundational and core offering the practice will offer or an ancillary service. As with many things in urology, the answer is not straightforward and in reality, it is a little bit of both, though I tend to think of UDS as an ancillary service for most practices.

Core services urologists must offer include basic history and examination ability, cystoscopy and access to and interpretation of relevant lab and/or radiologic studies of the urinary tract. A urologist who cannot offer these basic services is really not practicing urology. UDS is an important test that urologists offer; however, a urology practice can exist without offering UDS and still thrive.

 

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Topics: Urodynamics Testing, urology, urodynamics interpretation, Urology Practice Trends

5 Patient Scenarios Where Urodynamics Are Appropriate

Posted by Dr. Peter Steinberg on May 3, 2019 5:04:45 PM

Urodynamics (UDS) testing is a critical tool for the urologist managing voiding dysfunction and incontinence.

 

Like all tests, there are certain scenarios where the results are more helpful than others and times when using a test is critical.

 

This blog posts explores several key situations when UDS is a critical test to consider.

 

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Topics: Urodynamics Testing, urodynamics

Down There: When You’re Not Talking About Australia!

Posted by Gerard M. DiLeo, M.D. on Oct 24, 2018 5:53:38 PM

The Great Divide. 


There is a great divide that segregates women away from the rest of mainstream medicine. It is a vague dividing line at best, separating what is “down there” from the rest of the female body. Obstetricians and gynecologists have done what they could to obliterate that dividing line by declaring their women’s health specialty a “primary care” specialty. Nevertheless, a vast chasm opens through which many female patients can fall.

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Topics: Urodynamics Testing, UroGynecology

Urodynamics (UDS) In Post-Radical Prostatectomy Incontinence

Posted by Dr. Peter Steinberg on Oct 11, 2018 3:58:56 PM

After radical prostatectomy (RP), nearly 5-10% of men may experience substantial issues with urine control. Immediately after surgery many men have issues, especially with stress leakage; however, most will regain an acceptable level of continence within 6-12 months of surgery. For this smaller group of men with persistent incontinence, however, urine control can be a substantial issue and some require additional intervention to restore continence. Urodynamics can be a helpful adjunct in this population.

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Topics: Urodynamics Testing, urodynamics, male urodynamics, Post-Operative Urodynamics

Annual UDS or Annual Ultrasound in Neurogenic Bladder?

Posted by Dr. Peter Steinberg on Sep 21, 2018 6:52:26 PM
Patients with neurogenic lower urinary tract dysfunction (NLUTD) are at high risk of having poor bladder compliance, making upper urinary tract injury a distinct possibility. Given the wide variety of causes of NLUTD and the risk of upper tract damage, it is critical to perform surveillance of these patients for deterioration in bladder function and upper tract injury. Two of the most popular methods of surveillance for these issues are annual renal ultrasound and annual urodynamics (UDS) testing.
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Topics: Urodynamics Testing, General Urology Information, Neurogenic Bladder, urology, Ultasound

UDS After Female Incontinence Surgery: Who, When and Why?

Posted by Dr. Peter Steinberg on Sep 6, 2018 7:07:41 PM

 

One of the most vexing clinical situations happens to be one of the best uses of urodynamics (UDS): ongoing symptoms after female incontinence surgery. These cases are challenging and patients are often not happy to have ongoing symptoms, new symptoms or worsening symptoms; however, appropriately utilized and interpreted, UDS can be key to helping these patients.

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Topics: Urodynamics Testing, urodynamics, incontinence, Post-Operative Urodynamics

Role of Urodynamics Before Prolapse Surgery

Posted by Clark Love on Jul 5, 2018 1:53:36 PM

The topic of urodynamic studies (UDS) before prolapse surgery is highly debated in urogynecology. There have been previous studies conducted on women who had prolapse and uncomplicated stress urinary incontinence (SUI). Currently, there is no possibility of a universal consensus for UDS before prolapse surgery in women who have concomitant symptomatic SUI. The issue is that there is currently no evidence that the surgery outcome will be altered or not by being given a UDS. Thus, we must test further using randomized studies to advance and see if UDS can be useful before prolapse surgery.

Preoperative UDS Should Be Performed

If a patient with a pelvic organ prolapse (POP) has either stages IIIa, IIc, or lp, she is more likely to have symptomatic vaginal bulging and asymptomatic for stress or urgency incontinence. This case is just one example of where preoperative USD should be performed before the prolapse surgery. It’s been found that POP and lower urinary tract symptoms (LUTS) usually coexist with each other. But, UDS involve objective assessments of any dysfunction in the urinary tract system. Some UDS could prevent and save people from POP. However, not many are willing to perform this option.

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Topics: Urodynamics Testing, urodynamics, pelvic organ prolapse

Urodynamics: Recommendations for Clinical Practices

Posted by Clark Love on Jun 26, 2018 4:18:33 PM

Urodynamic practices should be consistent throughout every medical practice. However, you will find that they often vary depending on clinics, companies, and between countries. This can often lead to procedures being uncomfortable and unnatural for patients, as there isn’t a set standard for explaining or performing the urodynamic testing. The ICS standardization steering committee has wanted to update the international continence society standard for making urodynamic testing consistent across all practices. They aim to add update and improve on testing through the use of reporting from patients after clinical care.

Patient Information & Preparation for Invasive Urodynamics

Before starting any urodynamic treatment, clinicians should prompt patients for past information, physicals, and prepare for the urodynamic treatment.

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Topics: Urodynamics Testing, urodynamics training

Why Urodynamics & UroCuff Tests Are Appropriate For Health Care Today

Posted by Clark Love on Dec 22, 2017 11:58:58 AM

In the US, over 17 million people suffer from daily urinary incontinence. When discussing the prevalence of incontinence, women are more predisposed to this condition. To get a better grasp on the seriousness of urinary incontinence, take a look at some facts:

  • Between the ages of 30 and 59, one in four women has had an episode of urinary incontinence
  • More than 50% of elderly people which are living at home or placed in specialized facilities have urinary incontinence
  • The good news is that 80% of those affected by urinary incontinence can be cured, or have their life improved.

 

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Topics: Urodynamics Testing, UroCuff

Case Study: How Urodynamics Saved Sarah’s Life

Posted by Clark Love on Oct 20, 2017 11:42:53 AM

In many instances, urodynamics are performed to diagnose relatively benign lower urinary tract disorders, such as stress urinary incontinence. However, sometimes urodynamics uncovers more serious diseases that require immediate attention, as was the case with Sarah, a 48 year old mother of three from New York. Here, we will share Sarah’s story about unexpectedly finding out she had cervical cancer after a routine urodynamics test.

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Topics: Urodynamics Testing

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