Guideline Indications for Urodynamic Testing Patient Preparation

American Urological Association (AUA) - Complex or unclear urinary incontinence, particularly - Avoid caffeinated and alcoholic drinks before the
in cases where initial conservative or surgical treatment procedure.
fails. - Discontinue medications affecting the bladder or
- Prior to invasive treatment for stress urinary sphincter unless otherwise advised.
incontinence if complex factors are present (e.g., - Patients should arrive with a comfortably full bladder,
previous surgery, neurogenic bladder, etc.). as they may be required to urinate before and during
- Patients with lower urinary tract symptoms (LUTS) the test.
who do not respond to first-line treatment, especially - If clean intermittent catheterization (CIC) is performed
when diagnosis remains uncertain. regularly, patients should be instructed to catheterize
- Patients with suspected bladder outlet obstruction in just before the test.
the presence of voiding symptoms, when diagnosis is - U/C Negative
uncertain based on clinical evaluation alone. -To prepare bladder diary for 2-3 days
International Continence Society (ICS) - Assessment of urinary incontinence when diagnosis is - Patients should avoid diuretics or medications
unclear or when treatment fails to relieve symptoms. affecting the bladder unless otherwise instructed.
- Evaluation of bladder function in patients with - Arrive with a full bladder; patients should be advised
suspected or confirmed neurogenic bladder, not to urinate for 1-2 hours prior.
particularly in patients with spinal cord injury, multiple - Drink water as needed to maintain hydration, avoiding
sclerosis, or other neurogenic conditions. caffeinated beverages.
- Patients with complex lower urinary tract symptoms - Any specific preparation related to neurological
(e.g., mixed urinary incontinence) requiring precise conditions (e.g., spinal cord injuries) should be tailored
diagnosis before invasive treatment. accordingly by the care team.
- Urodynamic studies may be considered when there is - U/C Negative
uncertainty about detrusor underactivity in patients -To prepare bladder diary for 2-3 days
with voiding dysfunction.
European Association of Urology (EAU) - Urodynamics may be used in cases of complex - Patients should be well-informed of the procedure to
incontinence, especially when conservative treatments reduce anxiety.
have failed or when surgery is considered. - Bring a recent list of all medications, especially any
- Evaluation of patients with refractory LUTS not related to bladder function.
responding to initial treatment, especially when an - Arrive with a moderately full bladder (patients should
invasive procedure is planned. refrain from voiding for 1-2 hours prior to the test).
- Assessment of detrusor overactivity in patients with - Instructions on fluid intake may be given, especially if
urgency incontinence or suspected neurogenic bladder hydration is a concern.
dysfunction. - U/C Negative
- Necessary for diagnosing underactive bladder when --To prepare bladder diary for 2-3 days
conservative or pharmacologic management fails.

*** Patients (especially old women with multiple pregnancies) who there will be a doubt for structural problems like Cystocele, Rectocele, or prolaps should be
referred to uro-gyne team to be examined.