Predictive Value of Urodynamic Studies for Overactive Bladder

The use of urodynamic studies (UDS) in overactive bladder (OAB) diagnosis is contested due to concerns of invasiveness, cost-effectiveness, and relative lack of impact on treatment strategy. We aimed to provide a comprehensive review of the role of UDS in the diagnosis of refractory OAB, while also providing a synthesis of recent studies on this topic.

Recent studies that endorse the use of UDS show that incorporation of UDS findings may increase patient compliance and satisfaction with OAB treatment. Studies suggest that this greater patient satisfaction may be attributed to the ability of UDS to better identify the unique pathophysiology of OAB for each patient. One study found that UDS is also useful in diagnosing comorbid conditions, thereby affording clinicians the ability to individually tailor treatment. However, other studies showed that UDS did not significantly change the diagnosis and management in cases of uncomplicated OAB.

The use of UDS in the diagnostic algorithm of OAB may depend on the degree of certainty needed by individual providers to make a diagnosis and the extent to which findings would change the course of treatment. Individual patient history, clinical manifestations, and reported symptoms will influence further the appropriateness of UDS in given scenarios. Future studies are needed to better delineate the role of UDS in the assessment and management of refractory OAB.