Ambulatory Urodynamic Findings Change Patient Outcomes
Abstract
Objectives Whilst ambulatory urodynamics (aUDS) may be used as a second-stage test for patients with refractory
lower urinary tract symptoms (LUTS) having non-diagnostic conventional urodynamics (UDS), the evidence for their
use is limited. We have assessed the diagnostic utility and consequent symptomatic outcome of aUDS in patients with
refractory LUTS.
Methods A retrospective review of a prospectively acquired urodynamics database was made of 84 consecutive
patients (23 male) with a median age 50.5 years (range 18 to 79) having aUDS following non-diagnostic or
contradictory baseline UDS over a 12-month period. Patient demographics and urodynamic and clinical diagnosis
before and after aUDS were recorded. Forty-six patients (55%) had formal urinary symptom assessment recorded
before and a minimum of 6 months following aUDS-related change in management.
Results Eighty-two patients (98%) had a urodynamic diagnosis made following aUDS, 57(68%) of whom
had detrusor overactivity (DO); the final 2 patients had no abnormalities detected on aUDS. Change in primary UDS
diagnosis occurred in 66 patients (79%). Of these 66 patients, 59 (89%) also had their clinical diagnosis changed, and
55 (83%) had their management pathway changed. There was a significant improvement in urinary symptoms
6 months following aUDS.
Conclusion Change in primary diagnosis following aUDS led to a significant change in treatment care pathway and
resulted in significant improvement in urinary symptoms.
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