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5.7. Urodynamics Laboratory

  1. The Chief, SCI Service and/or Chief, Urology Service, is responsible for: 
    1. The planning and administration of the urodynamic laboratory; 
    2. Providing consultation to other services requesting urodynamic studies; 
    3. Ensuring the radiology department routinely evaluates the radiographic equipment; 
    4. Ensuring the staff performing fluoroscopic procedures wear film badges; 
    5. Ensuring that the rates of post-study infections and autonomic dysreflexia are tracked;
    6. Ensuring the clinical and laboratory records obtained from all examinations are included in the patient's medical record.
  2. All patients must be offered a complete urodynamics study during the initial admission. Non-invasive tests are to be used before urodynamic studies, where feasible.
    1. Urodynamic assessment includes a cystometrogram (CMG) with simultaneous sphincteric pressure measurement under fluoroscopy and/or rectal sonography.
    2. If concurrent fluoroscopy is not available, a separate voiding cystourethrogram (VCU) must be done.
    3. Urodynamic studies are to be done 3 to 6 months after injury, or after return of bladder activity, whichever comes first (urodynamic studies need to be done following stabilization of bladder function, which is typically, completely stable by 6-18 months post-injury).
    4. Only competent personnel knowledgeable in urodynamics, urodynamic instrumentation, and technical analysis may perform and/or assist in the study.
    5. A physician competent in urodynamics and/or uroradiology must be available for consultation during the study.
    6. Appropriate emergency support and equipment must be available to the urodynamics suite.

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