Objective
To prospectively evaluated the utility of urodynamic evaluations (UDS) ordered in
a tertiary referral center as part of a quality improvement project.
Methods
Patients with UDS ordered by 3 subspecialty physicians were included. Physicians were
surveyed when ordering UDS and at the post-UDS clinic visit to assess indications
for UDS, pre- and post-UDS diagnosis, treatment plan, confidence level, and perceived
helpfulness of UDS. UDS trained nurses conducting studies were surveyed on patient
reported reproducibility of their symptoms and perceived difficulty of UDS.
Results
From April 2017 to October 2017, 127 UDS were included of which 102 met study criteria.
UDS were done for neurogenic (23%) and non-neurogenic lower urinary tract symptoms
(76%). The majority were conducted for incontinence evaluation (79%), or after prior
lower urinary tract surgery (33%). UDS nurses reported 90% of UDS fully or partially
reproduced patient symptoms. Nurses found 18% of UDS difficult due to catheter malfunctions,
physical limitations, and communication abilities. Post-UDS, providers found 97% of
UDS interpretable. UDS resulted in a change in treatment plan in 78% of patients.
On a Likert scale, mean pre-UDS confidence level was 2.9 ± 0.8 (range 0-5). This increased
to 4.1 ± 0.6 post-UDS with 76% of evaluations having a change of at least 1 point.
Conclusion
UDS in a tertiary referral center result in change in patient treatment plans over
three-fourths of the time with high rates of interpretability.
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Article info
Publication history
Published online: January 14, 2019
Accepted:
January 4,
2019
Received:
November 8,
2018
Footnotes
Financial Disclosures: The authors have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter discussed in the manuscript.
Identification
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© 2019 Elsevier Inc. All rights reserved.
