Bladder management is a hugely important factor that needs to be taken into consideration when it comes to managing patients with spinal cord injury (SCI). In the following blog post, we will discuss differences between ambulatory urodynamics and conventional urodynamics on patients with SCI.

According to this article¹, conventional urodynamic testing has multiple drawbacks mainly due to the unfamiliar circumstances for the individual, immovability of the instrument, expenses, restrictive position during the test as well as manual filling of the bladder (rather than natural filling). Therefore, fully ambulatory urodynamic monitoring systems have been developed, which enable the pressure in the abdomen to be measured in a perfectly non-invasive manner. The question is: how reliable are they and can we use the findings effectively?

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.

Bladder cancer is a relatively rare phenomenon in the United States – affecting fewer than 200,000 Americans annually – but can be serious when left untreated. Here, incontinence will be discussed relative to bladder cancer, which is a side effect of both the cancer itself and the treatment.

With recent changes to healthcare and reimbursement, interest in management service organizations (MSOs) has increased. In years past, these services have been met with caution, as they were judged to create more risk than reward. However, recently that balance has shifted. Here, ObGyn MSOs will be discussed.

When it comes to medical practice, the cost of doing business can be vastly different than for other small businesses. While building revenue is important, so is effective customer service and high-quality patient care.

As the model for reimbursement changes, efficient cost management is becoming a key component of the survival and stability of the independent medical practice.

Here, the types of costs associated with medical practices will be discussed, as well as why the variable cost structure is important.

Urodynamics Explained

Urodynamics is a blanket term for a series of tests that assess the functionality of the lower urinary tract. Numerous 

problems of the bladder and urethra which commonly affect both men and women can be diagnosed via urodynamics. Typically, these tests are ordered to diagnose issues such as urinary incontinence or prostrate problems, as well as before and after any type of surgery involving the pelvic organs or the urinary tract. Common symptoms that result in a doctor ordering urodynamics include incontinence, frequent urination, inability to urinate, weak urine stream, painful urination, nocturia, recurrent urinary tract infections, and difficulties emptying the bladder entirely.  The types of urodynamic tests commonly performed include the following:

Anorectal manometry is a diagnostic technique that is intended to test how well the rectum and anal sphincter are functioning. In the blog post below, when this test is commonly prescribed, as well as an explanation of the procedure, will be described.

What is Anorectal Manometry?

Anorectal manometry is a minimally invasive diagnostic procedure that is simple to perform, but it requires complex equipment and well trained nursing staff. This test is used to measure the patient’s contractility in his or her anus and rectum. A catheter with a balloon attached is inserted directly into the patient’s rectum. The balloon is inflated, and pressure readings from the sphincter and rectum are recorded. One purpose of anorectal manometry is to test the ability of the muscles and tissues surrounding the balloon is to relax in response to pressure. For instance, if rectal muscles and sphincter do not relax when the balloon is inflated, paralysis of the colon could be to blame.

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.

The term outsourcing tends to have a negative connotation, with immediate thoughts of lost jobs to lower-income workers. However, in the medical field there are many reasons to outsource certain tasks and testing, which not only saves costs but allows medical personnel to have a more singular focus throughout their workday. Here, ways in which a large urology practice should outsource urodynamics by utilizing a qualified vendor to provide diagnostic testing will be discussed.

In today’s medical marketplace, physicians such as urologists and ObGyns are finding it more and more difficult to keep doors open in the face of deceased reimbursements and patients who lack medical insurance. Additionally, attracting new patients is harder than ever, thanks to the prevalence of websites which allow patients to rate their doctors, sometimes leaving bad reviews which do not adequately depict the situation from both sides.