Urodynamic Evaluation: Traditional, Video, and Ambulatory Approaches

Urodynamic techniques allow for an objective assessment of the lower urinary tract system, with the aim of interpreting the different array of subjective symptoms and establishing a precise diagnosis. It compiles a wide variety of tests that range from less invasive and simpler ones, such as the bladder diary and the uroflowmetry, to others more complex and invasive, such as the filling cystometry, the pressure-flow study and videourodynamics. Anatomy and physiology of the female lower urinary tract have particular differences from the male counterpart which implies a distinct approach and interpretation. In women, the main complaints occur mostly during the filling phase of the micturition cycle and the physiological bladder outlet resistance is less pronounced. Therefore, urodynamics have an important role in the assessing the differential diagnosis of overactive bladder and the underlying mechanisms of urinary incontinence, predicting the outcomes of female urology surgery, and characterizing the phenotype of systemic neurological disorders. Nevertheless, standardization and clinical correlations are the still lacking, so effort should be made to report further data and develop less invasive and more accurate techniques.