Pre-operative urodynamic assessment

The pre-operative urodynamic assessment is a complete functional exploration systematically performed before certain urological operations. Its purpose is twofold: to confirm the functional diagnosis that justifies the surgery and to provide baseline data for evaluating the post-operative result. Before prostatic deobstruction surgery (transurethral resection, adenomectomy, laser), the pre-operative assessment confirms bladder outlet obstruction by means of the pressure-flow study and detects any associated detrusor underactivity. In the absence of confirmed obstruction, surgery may not improve the patient's symptoms. Before urinary incontinence surgery in women (suburethral sling, colposuspension), the assessment evaluates the urethral closure pressure, bladder capacity, compliance and detrusor stability. These parameters guide the choice of surgical technique and allow the patient to be informed about the chances of success and the risks of complications. This assessment is also indispensable before the placement of an artificial urinary sphincter or a sacral neuromodulator, and before bladder augmentation. It represents an important medico-legal step because it documents the pre-operative functional state and objectively justifies the indication for surgery.