title: The role of ambulatory urodynamics in investigation of female urinary incontinence.
abstract: OBJECTIVE
  Lower urinary tract symptoms (LUTS) impact upon quality of life and occur in women of all ages. The National Institute for Clinical Excellence states that ambulatory urodynamic monitoring (AUM) should be used as a second-line investigational modality; however, its use is becoming more frequent. AUM provides a valid second line to conventional urodynamic methods that may be more widely used.
  
  
  METHODS
  A literature review was undertaken to assess evidence for the use of AUM alongside a retrospective review of patients undergoing AUM at a tertiary care centre and symptom reporting at a follow-up visit. Both these methods included evidence for pathology detection, technical ease of use, recreation of symptoms and patient experience, allowing comparison of literature results to those experienced in day-to-day use.
  
  
  RESULTS
  The literature shows AUM to have sensitivity superior to that of other urodynamic investigations. However, evidence suggests this correlates less well with clinical effectiveness. Patients felt AUM was superior in recreating their symptoms, and they tolerated the procedure well. The increased technical demands of AUMs, however, meant that traces were more commonly harder to interpret than with conventional urodynamics. Our experience correlates well with the existing literature, suggesting increased symptom diagnosis; 63.2 % of diagnoses correlated well with symptoms.
  
  
  CONCLUSIONS
  AUM remains an important urodynamic method to supplement conventional urodynamics. Evidence suggests it is superior in LUTS diagnosis, but its technical difficulty can affect results.
authors: Birmingham City Hospital, Dudley Road, Birmingham, B18 7QH, UK.
authors: Jonathan
authors: J
authors: Chester
authors: Birmingham Women's Hospital NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK.
authors: Philip
authors: P
authors: Toozs-Hobson
authors: Birmingham Women's Hospital NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2TG, UK. f.israfilbayli@nhs.net.
authors: Fidan
authors: F
authors: Israfil-Bayli
mesh_terms: D003950:Diagnostic Techniques, Urological; D005260:Female; D006801:Humans; D018670:Monitoring, Ambulatory; D014549:Urinary Incontinence / Q000175:diagnosis*; D014563:Urodynamics
keywords: Ambulatory; Cystometry; Incontinence; Urinary symptoms; Urodynamics