Executive summary: The International Consultation on Incontinence 2008—committee on: “Dynamic Testing”; for urinary or fecal incontinence. Part 2: Urodynamic Testing in male patients with symptoms of urinary incontinence, in patients with relevant neurological abnormalities, and in children and in frail elderly with symptoms of urinary incontinence

Abstract

Aims:The members of 'The International Consultation on Incontinence 2008 (Paris) Committee on Dynamic Testing' provide an executive summary of the chapter 'Dynamic Testing' that discusses (urodynamic) testing methods for patients with signs and or symptoms of urinary incontinence. Testing of patients with signs and or symptoms of fecal incontinence is also discussed. Methods: Evidence based and consensus committee report. Results: The chapter 'Dynamic Testing' is a continuation of previous Consultation reports added with a new systematic literature search and expert discussion. Conclusions, based on the published evidence and recommendations, based on the integration of evidence with expert experience and discussion are provided separately, for transparency. Conclusion: This second part of a series of three articles summarizes the committee's recommendations about: 'Urodynamic testing of male patients with symptoms of incontinence, of patients with relevant neurological abnormalities, testing of children and of frail elderly with symptoms of incontinence' and includes only the most recent and relevant literature references. Neurourol. Urodynam. 29:146-152, 2010. ß 2009 Wiley-Liss, Inc.Key words: consensus committee; incontinence (children); incontinence (frail elderly); incontinence (male); incontinence (neurologic); urodynamics INTRODUCTIONSubsequent to the first two reports of the International Consultation on Incontinence (ICI) 1,2 the chapter ''Urodynamic Testing'' was renamed ''Dynamic Testing'' in the third and fourth reports because of the additional inclusion of recommendations on the (diagnostic) management of fecal incontinence. 3 We (members of ''The ICI 2008 Committee on Dynamic Testing'': ICI-CDT) provide an executive summary of the chapter ''Dynamic Testing'' in the fourth ICI-report on incontinence. 4 The ICI-report, with the ICI-CDT chapter discussed here, has the intention to provide recommendations on the basis of the most reliable evidence for the current state of assessment of the patient with urinary or fecal incontinence. To this aim, dedicated and systematic literature searches were performed on the basis of keywords and on the basis of articles related to references in the previous ICI-reports. Throughout the chapters' text ''conclusion(s)'': solely and entirely based on the published scientific evidence, and ''recommendation(s)'' are highlighted. The ''recommendations'' are the integration of scientific evidence with the expert group consensus, together with the discussion with the attendees during the ICI meeting. Conclusions are separated from recommendations to produce maximum transparency about the ''evidence base'' of the recommendations. Likewise obtained ''topics(s) for research'' are also highlighted in the text of the ICI-report. In this executive summary, we discuss the chapter ''Dynamic Testing'' from the ICI-report in three parts: The innovations in urodynamic techniques ''in general,'' the test characteristics and normal values of urodynamic studies (UDS) as well as the asse...

Comparison of water and air charged transducer catheter pressures in the evaluation of cystometrogram and voiding pressure studies

“…The characteristics of AC catheters enable the examiner and patient to adjust their positions without compromising the test or having to re‐calibrate the pressure sensors. Also, there is simpler set up with direct transmittal from the balloon to the External transducer and a dual catheter usage . This difference allows the clinician conducting the urodynamics study, the ability to concentrate on the pathophysiology rather than worrying about the many potential technological artifacts of water catheters.…”

A guide to indications, components and interpretation of urodynamic investigations

“…Elderly patients should not be considered differently from younger patients simply because of their age. However, with potentially multiple contributory factors, clinicians skilled in the care of elderly patients should be involved before any invasive investigations are performed …”

“…When urodynamic observations are performed in children, the clinician must acknowledge any social influences, physical demands and psychological stresses of the situation that may modify the child's behaviour and hence might alter the observation outcomes …”

Trends and Patterns of Urodynamic Studies in U.S. Males, 2000–2012

“…Urodynamic studies (UDS) are used to provide functional information regarding bladder storage and emptying in men with lower urinary tract symptoms (LUTS). [ 1 , 2 ] While invasive UDS may assist with the evaluation of LUTS, these costly procedures are associated with a risk of infection, urethral trauma and pain. [ 3 – 5 ] Despite the widespread use of UDS in the United States, limited population-based data exist regarding recent patterns and trends of these procedures among adult males.…”