Safe urodynamic practices in times of COVID-19: What can be accomplished and what can be added?

AIM: To present feedback, after applying national and international urodynamic study (UDS) recommendations for safe practice during the COVID-19 pandemic. METHODS: We created a checklist to assess the feasibility of performing UDS recommendations for safe practice during the COVID-19 pandemic from the first week of May 2021 to the last week of July 2021. RESULTS: One hundred patients were analyzed during the study period. We observed that all preventive recommendations for the steps that precede UDS could be followed in full. However, some guidelines for performing the exam were not feasible in all patients. We have successfully adopted other safety measures for all patients. CONCLUSIONS: The COVID-19 pandemic will likely persist for several more years. We believe that continuous improvement, revision, and updating of existing protocols and guidelines for the safe practice of UDS in times of COVID-19, as we propose in this study, should be encouraged.

Comparison of vesical pressure values achieved by Valsalva maneuvers: A standardization proposal.

AIMS: To perform a comparative evaluation of Valsalva maneuver techniques, in an attempt to identify the most suitable one for achieving leak point pressure (LPP) during the cystometric phase of the urodynamic study (UDS), in order to propose a method for technical standardization. METHODS: Urodynamic data from women with stress urinary incontinence at three urogynecological medical centers were randomly selected and prospectively analyzed. Valsalva maneuver was executed through forceful attempted exhalation against the dorsal surface of the hand (Group 1), through abdominal strain (Group 2), or through low-elasticity latex balloon-blowing (Group 3). Patients were classified based on age and higher vesical pressure value, as well as time to perform Valsalva maneuver. RESULTS: Initially, 1358 urodynamic studies were identified as eligible for analysis. Among these, 340 belonged to Group 1, 318 to Group 2, and 700 to Group 3. Valsalva maneuver accomplished through abdominal straining was more effective, inducing increased vesical pressure, across age groups. The same maneuver may be sustained for longer than the other two techniques. CONCLUSION: When performed through abdominal strain, the Valsalva maneuver was more effective for stress urinary incontinence urodynamic's investigation.