The role of urodynamic assessment in the diagnosis of lower urinary tract disorders

The relationship between clinical symptomatology and urodynamic findings was studied prospectively in 1000 unselected women with symptoms of lower urinary tract dysfunction. Women in the study were subjected to both clinical and multichannel urodynamic assessment. The symptom of stress incontinence was confirmed by urodynamic assessment to be associated with genuine stress incontinence (95%). However, it was also associated with sensory urgency (96%) and detrusor instability (64%). Other lower urinary tract symptoms were associated with a range of abnormal urodynamic findings. It was concluded that urodynamic assessment provided useful information in women with lower urinary tract disorders, in developing principles of diagnosis and management. EDITORIAL COMMENT: Once again the utility of urodynamic evaluation of women with lower urinary tract symptomatology is clearly apparent. Lower urinary tract symptoms are too unspecific to be the sole basis of treatment, especially surgical intervention. Although this conclusion has been reached by other investigators, there remain far too many clinicians in the fields of primary care, gynecology and urology who continue to doubt urodynamic testing. The fact remains, as shown again by Dr Clarke, that urodynamic assessment is essential in making a diagnosis and formulating a treatment plan.