Menzel Viktoria, Kontschak Livia, Sondermann Marcus, Grabbert Markus, Borkowetz Angelika, Mehralivand Sherif, Eisenmenger Nicole, Huber Johannes, Thomas Christian, Schultz-Lampel Daniela, Baunacke Martin
Klinik und Poliklinik für Urologie, TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Klinik für Urologie, Universitätsklinikum Freiburg, Freiburg, Deutschland.
Urologie. 2025 Apr 14. doi: 10.1007/s00120-025-02579-5.
Urodynamic studies (UDS) are an established diagnostic tool in urology. However, international studies, including those from Germany, indicate a decline in their use. This trend may be attributed to guideline adjustments and changes in indications.
The study aims to analyse the current practice and distribution of indications for UDS in urological clinics and practices in Germany.
Between March 2023 and October 2023, 259 urological clinics and a representative sample of 280 outpatient urologists nationwide were surveyed about their UDS procedures. Data on methods, personnel and indications were collected.
In all, 80% of clinics and 44% of practices participated. 58% of clinics performed fewer than 100 UDS annually. Only 15% of practices performed UDS themselves. Common procedures such as uroflowmetry (99%) and cystometry (98%) are widely implemented, whereas video urodynamics (53%) are less frequent. The most common indications in clinics are neurogenic bladder dysfunction (24%), overactive bladder (21%) and female stress incontinence (19%). Practices showed similar trends, with neurogenic bladder dysfunction (30%) and overactive bladder (26%) as primary indications. University hospitals and specialized centres performed UDS more often for complex conditions, while non-university clinics frequently addressed stress incontinence.
Despite declining numbers, UDS remain central to urological diagnostics. Indication patterns vary by clinic type. These results provide insights into the application of UDS in Germany and underline its important role in urological diagnostics.
尿动力学检查（UDS）是泌尿外科既定的诊断工具。然而，包括来自德国的研究在内的国际研究表明其使用量在下降。这种趋势可能归因于指南调整和适应证的变化。
本研究旨在分析德国泌尿外科诊所和诊疗机构中UDS的当前实践及适应证分布情况。
在2023年3月至2023年10月期间，对259家泌尿外科诊所和全国范围内280名门诊泌尿外科医生的代表性样本进行了关于其UDS操作的调查。收集了有关方法、人员和适应证的数据。
总计80%的诊所和44%的诊疗机构参与了调查。58%的诊所每年进行的UDS检查少于100例。只有15%的诊疗机构自己开展UDS检查。诸如尿流率测定（99%）和膀胱测压（98%）等常见检查广泛实施，而影像尿动力学检查（53%）则较少进行。诊所中最常见的适应证是神经源性膀胱功能障碍（24%）、膀胱过度活动症（21%）和女性压力性尿失禁（19%）。诊疗机构呈现出类似趋势，以神经源性膀胱功能障碍（30%）和膀胱过度活动症（26%）作为主要适应证。大学医院和专科医院针对复杂病情更常进行UDS检查，而非大学诊所则经常处理压力性尿失禁问题。
尽管数量在下降，但UDS仍是泌尿外科诊断的核心。适应证模式因诊所类型而异。这些结果为德国UDS的应用提供了见解，并强调了其在泌尿外科诊断中的重要作用。
