Role of urodynamic studies in the diagnosis and treatment of lower urinary tract symptoms

Urodynamic studies (UDSs) encompass a series of clinical tests, such as uroflowmetry, filling cystometry, pressure-flow studies and assessment of urethral closure (including urethral pressure profilometry and measurement of the leak-point pressure). Lower urinary tract symptoms are not always well correlated with the results of UDSs. Such studies are indicated in the following situations: (1) when conservative treatment is ineffective; (2) when invasive treatment is being considered; (3) for protection of the upper urinary tract by creating a low-pressure reservoir and control of urinary incontinence; (4) for evaluation of the effects of treatment; and (5) for biofeedback training. Video urodynamics is described as the gold standard of conventional UDSs. Characteristic features of various types of lower urinary tract symptoms, including urinary incontinence, bladder outlet obstruction and neurogenic bladder, can be identified by UDSs.