Video urodynamic studies and clinical outcome.

We have reviewed the clinical outcome in 64 patients having combined structural and functional lower urinary tract studies (video urodynamics). The results represent two years' experience of a unit encouraging referral only of those complex patients thought to need the combined study, rather than simple urodynamic measurements. The test's accuracy and its influence on management were not in question, and most patients (58%) were improved. The results suggest that the test is decisively useful in patients with obstruction, whether complicated by bladder instability or not. A poor stream or a neuropathic bladder were the important clinical pointers to this group. The great majority of patients suffering from stress incontinence were improved on review, whilst most of those with frequency and urgency of micturition were no better. The combined test may have given diagnostic confirmation here, but it did not bear importantly on outcome. Diagnostic certainty in these groups was therefore of doubtful, value, and dearly bought.