Urodynamics: the need for 'Preferred Providers'.

摘要

For clinicians dedicated to the treatment' of urinary dysfunction, urodynamics remains an essential tool in the evaluation and management of our patients. Urodynamics is not simply a diagnostic procedure such as a radiograph or electrocardiogram, but it is a dynamic test between the patient and the clinician, dependent upon the interaction between patient and provider for most compelling results. According to the ICS Standardization Committee report on Good Urodynamic Practices, "good urodynamic practice" comprises three main elements: (1) A clear indication for and appropriate selection of relevant test measurements and procedures, (2) Precise measurement with data quality control and complete documentation, (3) Accurate analysis and critical reporting of results. Thus, even before testing begins, the investigator must formulate the "urodynamic questions," which is the precise information that must be gained from the urodynamics assessment. As such, these studies must be individually tailored to meet the particular needs of each patient. The clinician is expected to monitor and actively participate in the urodynamics investigation. This is the opportunity to insure that the study is technically sound, and that the appropriate information is obtained. If it is not, the clinician should alter the study to achieve the appropriate information. The goal of the study is to reproduce the patient's symptoms and without the achievement of the goal, the results are simply meaningless pressure transduction curves.