Flow meter urine testing: a practical proposition in patients attending for urodynamics?

Area of Science:

• Urology
• Infectious Disease

Background:

• Urinary tract infections (UTIs) are a known complication following urodynamic testing.
• Current guidelines lack standardized protocols for pre-urodynamic urine analysis.
• Preventing UTIs is crucial to mitigate risks associated with invasive procedures.

Purpose of the Study:

• To establish a practical, non-invasive method for detecting UTIs prior to urodynamic investigations.
• To evaluate the efficacy of pre-urodynamic urine dipstick testing.

Main Methods:

• Patients provided a free-flow urine sample analyzed via dipstick before urodynamics.
• Urine dipstick analysis was also performed on a catheter-obtained urine specimen (CSU) for comparison.
• Flowmeters were meticulously cleaned between patients to prevent cross-contamination.

Main Results:

• Nitrite detection in free-flow samples showed 100% concordance with catheter specimens.
• Leukocyte detection was consistent in 89% of paired samples.
• Discrepancies in leukocyte results (11% of cases, predominantly in women) were attributed to vaginal contamination.

Conclusions:

• Pre-urodynamic urine dipstick testing of free-flow samples is a feasible and effective screening method.
• This approach avoids unnecessary catheterization, reducing the risk of bacteraemia.
• It allows for essential flowrate measurements to be performed safely.