Reproduction of Female Lower Urinary Tract Symptoms on Urodynamics

Objectives: Urodynamic testing (UDS) can be a valuable tool in the assessment of urinary incontinence and voiding dysfunction. The success of UDS in reproducing patients' symptoms has not been well defined. We sought to determine the ability of UDS to reliably reproduce various lower urinary tract symptoms and secondarily the ability of UDS to produce disparate findings not associated with patients presenting symptoms. Methods: Following Institutional Review Board approval, patient data was accumulated prospectively over 10 months. Notation was made of primary and secondary symptoms as well as if these stated symptoms were reproduced during the urodynamic procedure. Presenting lower urinary tract symptoms included for analysis were stress, mixed and urge incontinence, urgency, and obstructive symptoms. We also reviewed the number of disparate urodynamic observations that did not correlate with patient history. Results: Over a 10-month period, 127 women had interpretable data with respect to whether their presenting symptoms were reproduced during UDS. Presenting symptoms were successfully reproduced on 83% of UDS studies. Disparate urodynamic observations were noted in 60% of patients. Conclusions: Reproduction of patient symptoms during UDS occurred in the majority of cases if the patient was queried regarding this association. Additional disparate urodynamic observations were also noted in a majority of patients undergoing UDS. It remains unclear whether reproduction of symptoms during UDS in females ultimately results in improved interventional outcomes. The implications of new or unexpected UDS findings during UDS are unknown.