[Environment, patient information, and organization in a pediatrics urodynamics unit]

Urodynamic studies require patient cooperation, and this can be difficult in the pediatric age due to their invasive nature. Our aim was to assess the benefits of organization, facility design and information specifically adapted to children.

We describe the facility design and organization of the Urodynamics Unit at the Children's Hospital in Boston. Environmental factors are adapted to the pediatric age and aim to reduce the impact of the examination. There are child's objects, images and toys in the examining room. Parents are allowed to be in the room while the test is performed, and music is played during the procedure. We describe the information pattern and the behavior of the nurses and physicians to preserve the child's privacy. An information leaflet and a survey on symptoms is sent to parents before the test. Information is adapted to every age and aims to reduce parental anxiety towards the test and make them understand the need for the study. There are two premises for information: 1) every procedure will be explained to the child and parents, and 2) they will be told the truth.

An enhanced cooperation has been noted following these guidelines. Between 5 and 8% of the studies performed are not evaluable due to lack of cooperation from the patient and only two children have totally refused the test in the last two years (0.2%).

Cooperation among urologists and specialized nurses as well as attention towards the child's and parents' psychological factors can enhance the diagnostic yield of this test.