E-Posters-Is Video-urodynamic superior to traditional urodynamic study in changing treatment decision for female lower urinary tract symptom?

Is Video-urodynamic superior to traditional urodynamic study in changing treatment decision for female lower urinary tract symptom? - Sana Ansari, MD

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In this study, the authors aimed to determine if video-urodynamic study (VUDS) was superior to traditional urodynamic study (UDS) in changing the treatment decision for lower urinary tract symptoms (LUTS). They conducted a retrospective chart review of 156 women who underwent VUDS. The primary outcomes of the study were: 1) the frequency of fluoroscopic images providing relevant information for the treatment plan; 2) the frequency of fluoroscopic images impacting the diagnosis; and 3) the frequency of incidental vesicoureteral reflux (VUR) found on VUDS without UDS findings indicating increased risk of VUR.<br /><br />The study found that pertinent fluoroscopic findings influenced the treatment plan in 60 cases, particularly in cases of poor compliance on UDS, urine retention, and VUR. Additionally, fluoroscopic findings changed or added to the diagnosis in 38 cases, including bladder diverticula, VUR, detrusor-sphincter dyssynergia (DSD), and bladder neck obstruction. VUR was detected in 16 patients, with 9 being incidental findings. Prior renal imaging was significantly associated with finding VUR on VUDS.<br /><br />When comparing the UDS diagnosis with the documented VUDS diagnosis, 36.5% of cases had a different diagnosis and 47% had a drastically different treatment plan. Fluoroscopic findings of VUR had a significant change in diagnosis but a non-significant change in treatment plan. The authors concluded that fluoroscopic findings from VUDS do not significantly contribute to or change the treatment plan. They suggest that if there is a clinical concern for VUR, UDS with renal imaging would be able to detect findings or potential damage to the upper urinary tract without subjecting the patient to fluoroscopy with VUDS. These findings are consistent with previous studies on different populations.

Keywords

video-urodynamic study

VUDS

traditional urodynamic study

UDS

lower urinary tract symptoms

LUTS

fluoroscopic images

treatment decision

incidental vesicoureteral reflux

VUR