Understanding and Redefining the Role of Urodynamics in Pelvic Floor Disorders

Purpose of Review The goal of this study is to review current literature regarding the role of urodynamic studies (UDS) in evaluation of non-neurogenic patients with pelvic floor disorders of stress urinary incontinence (SUI), pelvic organ prolapse (POP), voiding dysfunction, and interstitial cystitis/bladder pain syndrome (IC/BPS). Recent Findings Rates of pre-operative UDS have decreased among women with SUI. Guidelines suggest UDS is not required for index SUI patients opting for surgical treatments. Non-index SUI patients are candidates for UDS testing if such objective information will better clarify symptomology or guide management decisions. Women undergoing POP repair should be evaluated for occult SUI via physical exam or UDS. Women with high grade POP may have associated LUTS which may impact outcomes. UDS can assist in developing adjunct treatments or guiding surgical repair. UDS should be considered in women with voiding dysfunction who fail empiric treatments. UDS should be used judiciously, but may offer invaluable insights for symptom etiology and guide management for women with various pelvic floor disorders.