To assess whether ambulatory urodynamic studies change in urodynamic diagnosis, clinical diagnosis and/or treatment in patients with non−diagnostic or symptomatically contradictory baseline urodynamics.

A retrospective analysis was performed on 84 consecutive patients of median age 50.5 years having ambulatory 
The urodynamic diagnosis, clinical diagnosis and management pathway were compared following conventional and ambulatory urodynamics.

Change in primary urodynamic diagnosis occurred in 66 (79%) patients and is as detailed in the table. Change in clinical diagnosis occurred following ambulatory urodynamics in 59/66 patients who had their urodynamic diagnosis changed on ambulatory urodynamics, of whom 55/59 also had their management changed. Ambulatory urodynamics confirmed a symptomatically contradictory urodynamic diagnosis in 18 patients. This resulted in a change in clinical diagnosis following ambulatory urodynamics in 10/18 who did not have their urodynamic diagnosis changed on ambulatory urodynamics of whom 10/10 had their management changed. Management was also changed in 4/8 of patients with no change in their urodynamic or clinical diagnosis post-ambulatory urodynamics. 2 (2%) patients were diagnosed as having ‘normal’ ambulatory urodynamics.

In patients presenting with a non-diagnostic or symptomatically contradictory urodynamic diagnosis at our tertiary referral functional urology centre in the UK, ambulatory urodynamic assessment provided a diagnosis in 98% of our patients. Only 2 of the patients in this dataset were diagnosed as having ‘normal’ ambulatory urodynamics.

Ambulatory urodynamics resulted in a change of primary urodynamic diagnosis in 79% of patients.  This resulted in a change in clinical diagnosis in 70% and management pathway in 66% of patients.