When should we use urodynamic testing? Recommendations of the Italian society of urodynamics (SIUD). Part 2 - Male and neurogical population.

BACKGROUND Recent studies in literature, have raised some doubts on the routine use of urodynamic testing. Many physicians and articles recommend a selective use of this tool, considering carefully risks and benefits. These recommendations are intended to guide clinicians in the right selection of the male and neurological patients to submit to an urodynamic evaluation. This is the second part of a previous article regarding the urodynamic recommendations in the female population. METHODS We reviewed the literature, regarding the use of UDS in male and neurological population with lower urinary tract symptoms (LUTS). Specifically, we analyzed and compared the guidelines and recommendations of the most important urology and uro-gynaecology 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. RESULTS The recommendations are provided for diagnosis and management of common LUTS in male and neurological population. CONCLUSIONS 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.