The use of urodynamic studies to help sort out bladder problems

Urodynamic studies are performed as part of the clinical investigation of selected patients with lower urinary tract dysfunction. These studies provide the clinician with information about lower urinary tract function and allow a more scientific approach to the management of the individual patient. Although one might consider a simple ultrasound scan (to measure a post-micturition bladder residual) or a urine flow test study as being a form of 'urodynamic' investigation, the term 'urodynamic study' is usually reserved for the more complex filling and voiding pressure studies i.e. a cystometrogram (CMG). These studies are usually combined with X-ray screening during the test and the data can be stored on video to enable playback at a later date. This latter study is referred to as a video cystometrogram (YCMG) and is the most common form of urodynamic investigation. More specialised urodynamic studies include ambulatory urodynamic studies (where the bladder is allowed to fill naturally with the patient's own urine), and upper tract studies (where the renal pelvis is filled directly via nephrostomy to investigate situations of equivocal pelvi-ureteric obstruction) '. This editorial will concentrate on situations involving video-urodynamic studies.