REVIEW   Free access

Minerva Urologica e Nefrologica 2020 February;72(1):58-65

DOI: 10.23736/S0393-2249.19.03443-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

When should we use urodynamic testing? Recommendations of the Italian Society of Urodynamics (SIUD). Part 1 - Female population

Andrea BRAGA ¹ ✉, Enrico FINAZZI AGRÒ ², Ester ILLIANO ³, Francesca MANASSERO ⁴, Martina MILANESI ⁵, Franca NATALE ⁶, Marco TORELLA ⁷, Donatella PISTOLESI ⁴, Cosimo DE NUNZIO ⁸, Marco SOLIGO ⁹, Maurizio SERATI ¹⁰

¹ Department of Obstetrics and Gynecology, Beata Vergine Regional Hospital, Mendrisio, Switzerland; ² Department of Urology, Tor Vergata University Hospital, Rome, Italy; ³ Department of Urology and Andrology Clinic, Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy; ⁴ Division of Urology, Department of Translational Research and New Technologies, University of Pisa, Pisa, Italy; ⁵ Department of Urology, Careggi University Hospital, University of Florence, Florence, Italy; ⁶ Department of Urogynecology, San Carlo of Nancy Hospital, Rome, Italy; ⁷ Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy; ⁸ Department of Urology, Sant’Andrea Hospital, Sapienza University, Rome, Italy; ⁹ Department of Women, Mothers and Neonates, Buzzi Children’s Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy; ¹⁰ Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy

Although, until a few years ago, the diagnostic power of urodynamic testing had never been questioned, recent studies in the literature have raised some doubts on the routine use of this tool. The benefits of the urodynamic studies (UDS) should be weighted against costs, time-consumption and patient discomfort. These recommendations are intended to guide clinicians in the right selection of the female patients to submit to a urodynamic evaluation. We reviewed the literature, regarding the use of UDS in female adults with lower urinary tract symptoms (LUTS) and pelvic floor dysfunction. Specifically, we analyzed and compared the guidelines and recommendations of the most important urology and uro-gynecology international scientific societies. These publications were used to create the evidence basis for characterizing the recommendations to perform urodynamic testing. A panel of 10 experts was composed and Delphi process was followed to obtain the panelist consensus. The final recommendations were approved by the unanimous consensus of the panel and compared with the best practice recommendations available in the literature. The recommendations are provided for diagnosis and management of common LUTS in female population. This review provides a summary of the most effective utilization of urodynamic studies for the global evaluation of patients with lower urinary tract symptoms and how to use them when really needed, avoiding unnecessary costs and patient inconveniences.

KEY WORDS: Urodynamics; Urinary incontinence; Lower urinary tract symptoms; Pelvic organ prolapse; Health planning guidelines