The Chief, SCI Service and/or Chief, Urology Service, is responsible for:
The planning and administration of the urodynamic laboratory;
Providing consultation to other services requesting urodynamic studies;
Ensuring the radiology department routinely evaluates the radiographic equipment;
Ensuring the staff performing fluoroscopic procedures wear film badges;
Ensuring that the rates of post-study infections and autonomic dysreflexia are tracked;
Ensuring the clinical and laboratory records obtained from all examinations are included in the patient's medical record.
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.
Urodynamic assessment includes a cystometrogram (CMG) with simultaneous sphincteric pressure measurement under fluoroscopy and/or rectal sonography.
If concurrent fluoroscopy is not available, a separate voiding cystourethrogram (VCU) must be done.
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).
Only competent personnel knowledgeable in urodynamics, urodynamic instrumentation, and technical analysis may perform and/or assist in the study.
A physician competent in urodynamics and/or uroradiology must be available for consultation during the study.
Appropriate emergency support and equipment must be available to the urodynamics suite.