Diagnostic evaluation

Although endoscopic and radiologic studies may identify structural abnormalities of the urinary tract in patients with voiding dysfunction, urodynamic study is the only test of function. Urodynamic evaluation in neurogenic dysfunction 1) characterizes detrusor function during bladder filling, 2) determines pressure and flow during micturition, 3) evaluates bladder outlet and urethra, and 4) diagnoses neuropathy. This article discusses the various urodynamic modalities available to the physician, including video-urodynamics, and examines two controversial areas in urodynamics: bladder outlet obstruction and mixed stress and urge incontinence.