Choosing Wisely:

Don’t perform cystoscopy, urodynamics or diagnostic renal and bladder ultrasound in the initial work-up of an uncomplicated overactive bladder patient.

Rationale and Comments: The initial evaluation of an uncomplicated patient presenting with symptoms should include history, physical examination and urinalysis. In some cases, urine culture, post-void residual urine assessment and bladder diaries may be helpful. More invasive testing should be reserved for complex patients, patients who have failed initial therapies (i.e., behavioral therapies and medications), or patients who have abnormal findings on their initial evaluation.
Sponsoring Organizations:
  • American Urogynecologic Society
  • Sources:
  • American Urological Association guidelines
  • Disciplines:
  • Urologic
  • References: • Gormley EA, Lightner DJ, Burgio KL, Chai TC, Clemens JQ, Culkin DJ, Das AK, Foster HE Jr, Scarpero HM, Tessier CD, Vasavada SP; American Urological Association; Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction. Diagnosis and treatment of overactive bladder (non neurognic) in adults: AUA/SUFU guideline. J Urol. 2012 Dec 1;188(6 Suppl):2455-63.

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