title: When should video be added to conventional urodynamics in adults and is it justified by the evidence? ICI-RS 2014.
abstract: OBJECTIVE
  To debate and evaluate the evidence base regarding the added value of video to urodynamics in adults and to define research questions.
  
  
  METHODS
  In the ICI-RS Meeting 2014 a Think Tank analyzed the current guidelines recommending video urodynamics (VUD) and performed a literature search to determine the level of evidence for the additional value of the imaging with urodynamic assessment of both neurogenic and non-neurogenic lower urinary tract dysfunction.
  
  
  RESULTS
  Current guidelines do not specify the added value of imaging to urodynamics. Recommendations are based on single center series and expert opinion. Standard imaging protocols are not available and evidence regarding the balance between number and timing of pictures, patient positioning, and exposure time on the one hand and diagnosis on the other hand is lacking. On the basis of expert consensus VUD is relevant in the follow-up of patients with spinal dysraphism. Evidence for the value of VUD in non-neurogenic lower urinary tract dysfunction is sparse. There is some evidence that VUD is not necessary in uncomplicated female SUI, but expert opinion suggests it might improve the evaluation of patients with recurrent SUI.
  
  
  CONCLUSIONS
  There is only low level evidence for the addition of video to urodynamics. The ICI-RS Think Tank encourages better reporting of results of imaging and systematic reporting of X-ray doses. Specific research hypotheses regarding the added value of imaging are recommended. The panel suggests the development of standards for technically optimal VUD that is practically achievable with machines that are on the market.
authors.affiliation: Department of Neuro-Urology, University Hospital, Bonn, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Anding
authors.affiliation: Department of Urology, University Medical Center Utrecht, Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Rosier
authors.affiliation: Department of Surgery, University Connecticut Health Center, Farmington, Connecticut.
authors.forename: Phillip
authors.initials: P
authors.lastname: Smith
authors.affiliation: Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Gammie
authors.affiliation: Department of Urogynaecology, King's College Hospital, London, United Kingdom.
authors.forename: Ilias
authors.initials: I
authors.lastname: Giarenis
authors.affiliation: Department of Urogynaecology, King's College Hospital, London, United Kingdom.
authors.forename: Angela
authors.initials: A
authors.lastname: Rantell
authors.affiliation: Department of Urology, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom.
authors.forename: Nikesh
authors.initials: N
authors.lastname: Thiruchelvam
authors.affiliation: Urology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Arlandis
authors.affiliation: Department of Urogynaecology, King's College Hospital, London, United Kingdom.
authors.forename: Linda
authors.initials: L
authors.lastname: Cardozo
mesh_terms: D000328:Adult; D003950:Diagnostic Techniques, Urological; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D001743:Urinary Bladder / Q000503:physiopathology*; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000175:diagnosis* / Q000503:physiopathology; D014563:Urodynamics; D014741:Video Recording
keywords: guidelines; lower urinary tract dysfunction; neurogenic; video urodynamics; x-ray