While our blog is typically rather serious, we thought we would switch gears, have a little fun, and post a few jokes about urology. Hopefully they will make you smile.  

There’s no real love for waiting rooms. Call it the perpetual suspense, the white-coat syndrome lingers behind all modern chic designs. It’s time for practices to generate a greater practicality and explore deeper into human psychology behind waiting room worry.

My company provides advanced diagnostic testing services (primarily urodynamics testing, anorectal manometry testing, and other incontinence related services) to practices all over the country.

Through our work, we are exposed to practices at all profit levels from those that are hugely profitable to those that can barely pay the bills.  Based on our work, we have compiled a few ideas below that should help any practice be more profitable.  We hope that one or two will hit the mark for you.

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.

Urodynamic services provide valuable information when it comes to the urinary health of patients due to their interaction with medications, drugs, and other substances. However, some clinics doubt that urodynamic services make a difference in specific populations of people. To test this theory Suskind AM, Cox L, and Clemens JQ et al. (2017) decided to test the value of urodynamic services within an academic specialty referral practice. The objective of the study was to demonstrate that UDS services could provide useful information for correct medication doses in patients and other drugs.

Patients & Pre-screening

The perspective questionnaire was designed to determine the use of UDS in clinical practices. Each patient who was invited to be in the study was 18 years or older and were either male or female. Five clinics asked their patients if they wanted to participate in the study if they were coming for a UDS service. They were then prompted with a pre-questionnaire asking their race, gender, age, and if they had previously used UDS services. They were also asked if they had any history of pelvic radiation and neurological conditions.

Urodynamic procedures can be scheduled for reimbursements through Medicare and other insurance companies. You will need to know the exact codes listed below in the article to help build a proper case for calculating how much you can be reimbursed for. The following information is a guide to help you estimate your reimbursement. However, not all reimbursements will be accepted. Contact your insurers for an assessment to check if you qualify for urodynamic procedure reimbursements. Each insurance office has strict policies and guidelines on whether you will get accepted or denied your reimbursement.

Urodynamics testing requires very well-trained staff in order to determine the basis and progression of urologic diseases. Typically, UDS training is provided by the equipment manufacturers, but there are other viable training options in the market.

In the following article we focus on this study and discuss the effects of the uroselective α1-blocker tamsulosin on urodynamic parameters in male patients with type I primary bladder neck obstruction. Moving forward, an obstruction with high voiding pressure accompanied by poor flow and narrowing at the neck of the bladder with concomitant silent external sphincter on electromyography forms the basis for primary bladder neck obstruction. Alpha blockers, which are used in the treatment of primary bladder neck obstructions do not have evidence for objective urodynamic efficacy.

Let’s delve into the topic. Available treatment options for bladder neck obstruction are observation of the patient with follow-up, clean intermittent catheterization or bladder neck incision, alpha blockers. Studies conducted to assess the efficacy of the pharmacological approach are nonrandomized and small.

The storage and elimination of urine are regulated by neural circuits in the brain and spinal cord to coordinate function between the urethra and the urinary bladder. During micturition, the elimination of urine is facilitated by bladder wall contraction as well as urethral wall and pelvic floor muscle relaxation. In the following article, we will discuss discuss this study: Randomized Controlled Trial to Assess the Impact of Intraurethral Lidocaine on Urodynamic Voiding Parameters.

Lower urinary tract symptoms (LUTS) lead to incomplete bladder emptying, decreased quality of life, increased healthcare use, decreased workplace productivity and impact in intimate relationships. Some of the approaches to improve the condition such as