¿El estudio videourodinámico modifica la actitud terapéutica frente al estudio urodinámico?

Introduction: Urodynamics is a diagnostic study that assesses the function of the lower urinary tract by measuring pressure and flow during bladder filling and emptying. When combined with contrast instillation during bladder filling and radiological imaging, the urodynamic study (UDS) becomes a videourodynamic study (VUDS). Objective: to evaluate whether performing VUDS leads to changes in the therapeutic approach compared to conventional urodynamic studies. Materials and method: a descriptive study was conducted on the videourodynamic tests performed in our unit. Variables collected included sex, age, presence and type of prior neurological disease, as well as previous urodynamic diagnoses and videourodynamic findings during filling and voiding phases. It was then analyzed whether VUDS led to a change in treatment. Results: data were collected from a total of 30 patients, 13 women (43 %) and 17 men (57 %). All but two had undergone a UDS. A neurological condition was present in 66 % of patients (N=20), with multiple sclerosis being the most common. VUDS did not change the treatment plan in 43 % of patients (N=13). In these cases, although no new pathology was identified, VUDS helped rule out more severe conditions such as vesicoureteral reflux (VUR). In 57 % (N=17), VUDS led to a modification in treatment. One patient underwent surgical intervention. In 16% (N=5), intravesical treatment with botulinum toxin and/or Deflux® was administered. In 36% (N=11), pharmacological treatment was initiated. Discussion: VUDS may be necessary as a first-line diagnostic tool. Conclusions: VUDS changed the therapeutic approach in more than half of the cases, suggesting that its use may support earlier and more targeted interventions to prevent renal function deterioration.