Dr. Jason Kim

But just for straight idiopathic overactive bladder, the vast majority of the time, I don't really get any other testing done.

We've shifted for non-neurogenic patients.

Actually, most of our practice has shifted to ambulatory aerodynamics.

I just feel like it gives us a better result.

We know that patients with overactive bladder, maybe only 40% of them have detrusor overactivity on conventional urodynamics.

Also, studies even as early as the 80s showed that ambulatory urodynamics is a higher yield for things like detrusor overactivity.

And traditional urodynamics is only a snapshot in time, maybe 15, 20 minutes of filling in an artificial environment.

Ambulatory urodynamics now often lets us

place a bladder sensor in overnight, and we can capture events such as nocturia.

I have a cohort of younger women that seem to have multiple episodes of urinary frequency right before bed.

I've never been able to capture that in the past with traditional urodynamics, and that's where I think the power of ambulatory urodynamics comes in.

Well, that's an interesting question.

I think traditionally we know.

I think it depends, number one, has a patient been seen by other providers?

So we have a cohort of patients who've been managed either by primary care physicians or gynecologists or general urologists who've tried maybe behavioral modification and medications.

And it's not uncommon.

I get patients who've had this experience.

Some of them for decades, some of them have been cycled on medications, five, six anticholinergic medications, and they've lost hope.

That's one cohort.

I do get a fair amount of patients who are treatment naive, who've had it for some time, maybe since the delivery of their kids, and they think it's just part of getting older.