Urodynamic practice in neuro-urological patients: techniques and clinical value

During the last decade a variety of urodynamic techniques have been developed. Despite this there is a tendency to be somewhat inflexible in the application of urodynamics; as soon as the investigator becomes familiar with one method he tends to use it for all his urodynamic evaluations. A short survey gives information about the most popular urodynamic methods with their combinations, as well as their clinical value for paraplegics. The type and number of urodynamic techniques used at the Rehabilitation Centre Bad Häring during the last 6 years demonstrate that extensive facilities are desirable. This gives the flexibility to choose the proper technique, giving maximal information for the individual patient with minimal costs. The combination of cystometry with X-ray videography (the simplest form of videourodynamics), is the most frequent method used, whereas the time consuming combined pressure-flow-EMG-X-ray-video-studies are only used for special indications (approximately 10 per cent of all our urodynamic studies). In order to obtain information of clinical value sometimes a compromise is necessary in order to find the method somewhere between what we would like to measure and the disturbance caused to the patient.