2026 Urogynecology for the Advanced Practice Provider-Urodynamics: The Good, The Bad, and The Ugly

Video Transcription

Video Summary

The lecture explains urodynamics/neurodynamics as a simple but highly technical test used to answer specific clinical questions about lower urinary tract function. The speaker emphasizes that the study should not be ordered routinely, but only when it will help diagnose issues such as occult stress incontinence, bladder outlet obstruction, detrusor overactivity, poor bladder compliance, reflux risk, or detrusor sphincter dyssynergia (DSD).  <br /><br />A major theme is troubleshooting errors: catheter malposition, rectal contractions, falling EMG patches, and inaccurate machine-generated numbers can all produce misleading results. The speaker stresses that clinicians should always read the tracing themselves rather than relying on the computer interpretation.  <br /><br />Key concepts reviewed include the “nine C’s” of urodynamics, leak point pressures, compliance, pressure-flow studies, and EMG findings. Video urodynamics is highlighted as especially helpful in complex or neurogenic cases, where it can reveal obstruction, reflux, or unsafe bladder pressures.  <br /><br />Several cases illustrate common pitfalls, including false obstruction after sling surgery, missed stress incontinence when prolapse is not reduced, and confusing artifact with true DSD or detrusor overactivity. The overall message: urodynamics is valuable when used thoughtfully, interpreted carefully, and matched to the patient’s symptoms and clinical context.

Asset Subtitle

Speaker: Courtenay Moore, MD

Keywords

urodynamics

neurodynamics

lower urinary tract function

stress incontinence

bladder outlet obstruction

detrusor overactivity

detrusor sphincter dyssynergia

video urodynamics