Practice pattern of urologists in the rocky mountains region with regard to use of urodynamic studies

被引:4
作者
Daneshgari, F
Sorensen, C
机构
[1] Cleveland Clin Fdn, Inst Urol, Cleveland, OH 44195 USA
[2] Univ Colorado, Hlth Sci Ctr, Div Urol, Denver, CO 80262 USA
关键词
D O I
10.1016/S0090-4295(02)02557-8
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objectives. To evaluate the patterns of urodynamic studies (UDS) use among community urologists. Much controversy exists with regard to the need and indications for UDS in the clinical evaluation of urinary incontinence (UI) and voiding dysfunction (VD). Methods. A one-page questionnaire containing 11 questions was mailed to urologists practicing in the Rocky Mountains region. Physicians were asked about (a) their type of practice; (b) the number of patients with UI and VD they see per week; (c) the number of office procedures they perform on these patients; (d) the percentage of patients with Ul and VD for whom they use UDS for diagnostic clarification; and (e) the limiting factors to more frequent use of UDS. Results. Of the 127 questionnaires mailed, 51 (40%) were returned, and 49 (39%) of these were returned "completely filled out." No follow-up letter was sent nor was a telephone interview done. Most urologists (n = 38; 76%) indicated they are in private practice, 5 (10%) are in academics, 3 (6%) are in multispeciality groups, 2 (4%) are affiliated with a health maintenance organization (HMO), and 1 is in a hospital-based practice. Twelve (24%) see fewer than 5 UI patients per week, 21 (43%) see 5 to 10 UI patients per week, and 16 (32%) see more than 10 UI patients per week. The respective numbers for VD patients seen per week are 4 (8%), 12 (24%), and 33 (67%). Thirty (61%) and 32 (65%) of respondents use UDS in fewer than 5% of patients seen with UI or VD, respectively. Thirty-seven (76%) use cystoscopy in more than 5% of patients seen with UI or VD. Regarding limiting factors for more frequent use of UDS (of those 35 urologists giving single answers), 60% believed there was a lack of indication and 40% noted that UDS are too time-consuming or not cost-effective (20%), difficult to interpret (5.7%), or that they had no access to such equipment (14%). Conclusions. This study shows that the majority of urologists perform cystoscopy more frequently than UDS for diagnostic clarification of patients with UI and VD, and 40% of urologists do not perform UDS for reasons other than lack of indication. These results may indicate a need for more access to, and additional training in, UDS among urologists for management of UI and VD. (C) 2003, Elsevier Inc.
引用
收藏
页码:942 / 945
页数:4
相关论文
共 9 条
[1]   Do urinary symptoms correlate with urodynamic findings? [J].
Amundsen, C ;
Lau, M ;
English, SF ;
McGuire, EJ .
JOURNAL OF UROLOGY, 1999, 161 (06) :1871-1874
[2]  
Blaivas JG, 2000, NEUROUROL URODYNAM, V19, P553, DOI 10.1002/1520-6777(2000)19:5<553::AID-NAU2>3.0.CO
[3]  
2-B
[4]  
CARDOZO LD, 1980, BRIT J OBSTET GYNAEC, V70, P208
[5]   The role of urodynamic assessment in the diagnosis of lower urinary tract disorders [J].
B. Clarke .
International Urogynecology Journal, 1997, 8 (4) :196-199
[6]   Predictability of urodynamic findings based on the Urogenital Distress Inventory-6 Questionnaire [J].
Lemack, GE ;
Zimmern, PE .
UROLOGY, 1999, 54 (03) :461-466
[7]   Identifying patients who require urodynamic testing before surgery for stress incontinence based on questionnaire information and surgical history [J].
Lemack, GE ;
Zimmern, PE .
UROLOGY, 2000, 55 (04) :506-511
[8]   SYMPTOMS ANALYSIS FOR THE DIAGNOSIS OF GENUINE STRESS-INCONTINENCE [J].
VERSI, E ;
CARDOZO, L ;
ANAND, D ;
COOPER, D .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1991, 98 (08) :815-819
[9]   Cost-effectiveness of urodynamic testing before surgery for women with pelvic organ prolapse and stress urinary incontinence [J].
Weber, AM ;
Walters, MD .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2000, 183 (06) :1338-1346