Urodynamic studies (UDS) are invasive diagnostic tests for lower urinary tract dysfunction. The test may cause anxiety and embarrassment for many patients. In addition to utilising them for diagnosis, urology departments should aim to reduce patient anxiety and embarrassment. 
We performed a prospective, multi-centre audit of patient satisfaction of UDS in the UK.

Standard
The following standards were set:
•	Overall patient satisfaction rate should be greater than 60%.
•	Greater than 60% of patients should be willing to undergo a repeat test, if clinically necessary.
•	Anxiety rates should ideally be less than 50% of the maximum on a numerical rating scale (NRS).

Data was collected prospectively via a patient questionnaire. Patients self-completed the questionnaire on the day of their procedure. Patient demographic details were collected alongside symptoms and neurological status.
Numerical rating scale (ranging 1-5) data was collected for:
•	Pre-test and intra-test anxiety
•	Embarrassment
•	Pain
•	Overall satisfaction
Data were collated and analysed using Microsoft Excel and RStudio.

90 patients from five large centres across the UK were included in the study. 53% of patients were male and 47% were female. 
The predominant symptoms leading to UDS were storage LUTS (47% of patients), voiding LUTS (33% of patients), stress urinary incontinence (27% of patients) and urgency urinary incontinence (24% of patients).
Median anxiety levels were 3/5 and 2/5 on the NRS prior, and during the test, respectively. Mean and median pain scores were both 2/5. Levels of embarrassment were relatively low (median 2/5), whilst overall satisfaction was high (median 5/5; mean 4/5).
85% of patients were satisfied with the procedure (NRS 4/5 or 5/5) and 98% indicated they would be willing to have a repeat procedure in the future if clinically indicated.

The pattern of LUTS presenting for UDS in our cohort is different to population previously published population-based studies. Patient satisfaction with UDS is high in the UK, with the majority willing to undergo the test again. Moderate levels of pre-procedure anxiety are reduced slightly during the procedure.

The UDS service across the centres included are representative of UDS services across the whole of the UK. Patients in the UK are satisfied with the service they receive, although they are moderate levels of pre-procedure anxiety and mild-moderate levels of embarrassment. This anxiety existed despite the vast majority being aware of the details of the procedure (via information leaflet or having had procedure previously). Variations in LUTS compared to previous population-based studies is likely due to UDS patients being a subset of patients rather than a reflection of the whole population.