Evaluation of the Concordance Between Clinical Indications and Urodynamic Findings: A Single-Center Retrospective...

The diagnostic value of urodynamic investigation, which is used to characterise the underlying pathophysiology of lower urinary tract symptoms, varies depending on the appropriateness of its clinical indications. This study aimed to assess the correlation between urodynamic indications and findings and identify the clinical factors associated with this relationship.

Adult patients who underwent urodynamic evaluation between December 2023 and June 2025 at the Urology Department of the University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital were retrospectively evaluated. All assessments were conducted in accordance with the International Continence Society "Good Urodynamic Practice" guidelines. Demographic characteristics, laboratory data, ultrasonographic findings and uroflowmetry parameters were recorded. Concordance was defined as the detection of any clinically relevant urodynamic abnormality capable of explaining the patient's presenting symptoms or the indication for testing, and its association with clinical and urodynamic variables was statistically analysed.

A total of 144 patients were included in the study. The overall concordance rate between clinical indications and urodynamic findings was 66%. Neurological disorders (neurogenic lower urinary tract dysfunction, NLUTD) were present in 40.3% of patients, and concordance was significantly elevated in this group (p = 0.002). Patients with upper urinary tract involvement also demonstrated increased concordance (p = 0.005). Reduced maximum flow rate (Qmax), decreased voided volume and elevated post-void residual (PVR) volume were significantly associated with concordance (p = 0.005, p = 0.007 and p = 0.001, respectively).

Urodynamic evaluation is an essential tool in the diagnosis of lower urinary tract dysfunctions; However, its diagnostic yield varies across different clinical settings. Our findings indicate that the request for urodynamics is particularly justified in patients with NLUTD, upper urinary tract involvement, low flow rates or high PVR volumes. Therefore, urodynamic testing should be prioritised in cases with a high likelihood of diagnostic benefit, whereas its routine use should be carefully reconsidered in clinically uncomplicated or mild presentations, where the additional diagnostic yield may be limited.