REVIEW   Free access

Minerva Urologica e Nefrologica 2020 April;72(2):187-99

DOI: 10.23736/S0393-2249.19.03447-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

When should we use urodynamic testing? Recommendations of the Italian Society of Urodynamics (SIUD). Part 2 - Male and neurogical population

Andrea BRAGA ¹ ✉, Maurizio SERATI ², Ester ILLIANO ³, Francesca MANASSERO ⁴, Martina MILANESI ⁵, Franca NATALE ⁶, Marco TORELLA ⁷, Donatella PISTOLESI ⁴, Cosimo DE NUNZIO ⁸, Marco SOLIGO ⁹, Enrico FINAZZI AGRÒ ¹⁰

¹ Department of Obstetrics and Gynecology, EOC - Beata Vergine Hospital, Mendrisio, Switzerland; ² Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, Varese, Italy; ³ Division of Urology and Andrology Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy; ⁴ Division of Urology, Department of Translational Research and New Technologies, University of Pisa, Pisa, Italy; ⁵ Department of Urology, AOU Careggi Hospital, University of Florence, Florence, Italy; ⁶ Department of Urogynecology, San Carlo of Nancy Hospital, Rome, Italy; ⁷ Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy; ⁸ Department of Urology, Sant’Andrea Hospital, Sapienza University, Rome, Italy; ⁹ Department of Women, Mothers and Neonates, Buzzi Children’s Hospital, ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy; ¹⁰ Department of Urology, Tor Vergata University Hospital, Rome, Italy

Recent studies in literature, have raised some doubts on the routine use of urodynamic testing. Many physicians and articles recommend a selective use of this tool, considering carefully risks and benefits. These recommendations are intended to guide clinicians in the right selection of the male and neurological patients to submit to a urodynamic evaluation. This is the second part of a previous article regarding the urodynamic recommendations in the female population. We reviewed the literature, regarding the use of UDS in male and neurological population with lower urinary tract symptoms (LUTS). Specifically, we analyzed and compared the guidelines and recommendations of the most important urology and urogynecology international scientific societies. These publications were used to create the evidence basis for characterizing the recommendations to perform urodynamic testing. A panel of 10 experts was composed and Delphi process was followed to obtain the panelist consensus. The final recommendations were approved by the unanimous consensus of the panel and compared with the best practice recommendations available in the literature. The recommendations are provided for diagnosis and management of common LUTS in male and neurological population. This review provides a summary of the most effective utilization of urodynamic studies for the global evaluation of patients with LUTS, and how to use them when really needed, avoiding unnecessary costs and patient inconveniences.

KEY WORDS: Urodynamics; Urinary incontinence; Lower urinary tract symptoms; Urinary bladder, neurogenic; Guidelines as topic