Video-urodynamics

Video-urodynamics is the most complete and sophisticated test in the urodynamic arsenal. It combines a standard multichannel urodynamic assessment with real-time fluoroscopic (X-ray) or ultrasound imaging, making it possible to simultaneously correlate functional data (pressures, flows) and morphological data (bladder shape, opening of the bladder neck, reflux). During the test, the bladder is filled with a radio-opaque contrast agent instead of saline solution. This makes it possible to visualise on the fluoroscopy screen the shape of the bladder, the competence of the bladder neck, the possible presence of diverticula or vesicoureteral reflux, and the behaviour of the urethra during voiding. This technique is particularly valuable in neurological patients because it can detect vesicoureteral reflux or detrusor-sphincter dyssynergia, two complications that are potentially dangerous for the upper urinary tract. It also provides a simultaneous anatomical and functional evaluation in complex cases. Video-urodynamics is considered the absolute gold standard in the evaluation of complex bladder and sphincter dysfunction, particularly in neurological patients, children with urogenital malformations and after failed incontinence surgery.