E-Posters-Ambulatory Urodynamic Monitoring: How Often Does it Change our Diagnosis and is it Needed?

Ambulatory Urodynamic Monitoring: How Often Does it Change our Diagnosis and is it Needed? - Richard Flint

Pdf Summary

Ambulatory urodynamic monitoring (AUM) is a specialized investigation used when conventional tests cannot explain lower urinary tract symptoms. However, its impact on diagnosis and management is not well understood. This study aimed to determine how often AUM changed the diagnosis and management of patients, as well as to identify any predictive factors for diagnosis change.<br /><br />The study involved 145 adult female patients who underwent AUM in a urogynaecology centre. The most common presenting symptoms were urgency and urgency urinary incontinence. The main indication for AUM was suspicion of detrusor overactivity (DO) not demonstrated on conventional tests. The results showed that AUM led to a change in diagnosis for 72.42% of patients. Among those with normal conventional test results, AUM led to a new diagnosis of DO, urgency urinary incontinence, low capacity, or inconclusive results.<br /><br />AUM had various impacts on management, including initiating medication, proceeding with surgery, deferring surgery, or changing patient counseling. Further analysis showed that there were no predictive variables on conventional tests that could accurately predict the outcomes of AUM.<br /><br />In conclusion, AUM is an important test when there is diagnostic uncertainty after conventional tests. It significantly changes diagnoses and allows for tailored treatment options, reducing side effects and improving treatment efficacy. AUM is particularly beneficial for patients with mixed symptoms scheduled for continence surgery, as it helps diagnose and treat conditions that may have been missed otherwise. The study suggests that AUM should be considered in all cases of diagnostic uncertainty.

Keywords

Ambulatory urodynamic monitoring

lower urinary tract symptoms

diagnosis change

predictive factors

adult female patients

urogynaecology centre

detrusor overactivity

conventional tests

diagnostic uncertainty

tailored treatment options