Noninvasive Techniques in Urodynamics: An Update

Introduction

Urodynamics has been developed circa 1970, mainly to investigate lower urinary tract dysfunctions (LUTD). Urodynamic studies (UDS) have two basic aims: to reproduce the complaint evoked by the patient and to propose a pathophysiological explanation of the lower urinary tract symptoms (LUTS) from the urodynamic findings.

Abstract

PURPOSE

From the beginning of urodynamics, clinicians were aware that the method was invasive, expensive, time consuming, and had some morbidity. A consequence was the suggestion of many noninvasive methods to evaluate lower urinary tract dysfunctions. Our purpose was to list these methods with special interest for the methods that eliminated the drawbacks of urodynamics and for new methods.

MATERIALS

A PubMed search of published literature on noninvasive methods in urodynamics until October 2010 was performed.

RESULTS

Except for the first historical attempts (voiding distance, drop spectrophotometer), methods were broadly classified by their incidence on the flow. Many techniques required a complex and expensive equipment (Doppler ultrasound, functional brain imaging) and some caused adverse events (cuff, condom). Controversies existed when different measurement techniques were used (bladder ultrasound). Some techniques needed further studies (near infrared). The simplest methods (PCR, D index) fulfilled the outgoings.

CONCLUSION

Noninvasive urodynamics is a large challenge and is not solved. Some methods, which can be applied to man and woman, are promising: ultrasound to assess lower urinary tract dysfunction when a standardization will be obtained, and brain imaging to give a better understanding of the pathophysiology of micturition.

Keywords

Urodynamics, noninvasive, lower urinary tract dysfunction, lower urinary tract symptoms