PDF(Pubmed)
Abstract：
BACKGROUND: The number of urodynamic studies (UDS) has been declining steadily in recent decades, yet the reasons behind this trend remain poorly understood. This study aims to investigate the structural aspects of UDS in urology and explore the factors contributing to this decline.
METHODS: We surveyed all urological departments performing UDS as well as a representative sample of private practices in Germany in 2023. We examined structural situation, waiting times, capacities and limitations of UDS. All invasive urodynamic examinations were defined as UDS.
RESULTS: In 2019, 259/474 (55%) urological departments in Germany performed UDS. 206/259 (80%) urological departments responded to the survey. 163/200 (82%) urological departments stated that their capacities were exhausted, a main reason being lack of medical and nursing staff. 54.8% urological departments performed more than 50% of their UDS for referring physicians. Urological departments with a low number of UDS/year (≤ 100) showed a shorter waiting time (up to 4 weeks: 49% vs. 30%; p = 0.01), reduced UDS capacities (55% vs. 12%; p < 0.001) and these capacities were often not fully utilized (25% vs. 9%; p = 0.007). 122/280 (44%) office urologists responded to the survey. 18/122 (15%) office urologists performed UDS. Main reasons for not offering UDS were lack of personnel and low reimbursement.
CONCLUSIONS: In German urological departments, UDS capacities are consistently fully utilized, primarily due to staffing shortages. This trend towards centralization prompts questions about the role of UDS in urologists\' training.
METHODS: We surveyed all urological departments performing UDS as well as a representative sample of private practices in Germany in 2023. We examined structural situation, waiting times, capacities and limitations of UDS. All invasive urodynamic examinations were defined as UDS.
RESULTS: In 2019, 259/474 (55%) urological departments in Germany performed UDS. 206/259 (80%) urological departments responded to the survey. 163/200 (82%) urological departments stated that their capacities were exhausted, a main reason being lack of medical and nursing staff. 54.8% urological departments performed more than 50% of their UDS for referring physicians. Urological departments with a low number of UDS/year (≤ 100) showed a shorter waiting time (up to 4 weeks: 49% vs. 30%; p = 0.01), reduced UDS capacities (55% vs. 12%; p < 0.001) and these capacities were often not fully utilized (25% vs. 9%; p = 0.007). 122/280 (44%) office urologists responded to the survey. 18/122 (15%) office urologists performed UDS. Main reasons for not offering UDS were lack of personnel and low reimbursement.
CONCLUSIONS: In German urological departments, UDS capacities are consistently fully utilized, primarily due to staffing shortages. This trend towards centralization prompts questions about the role of UDS in urologists\' training.
摘要：
背景：近几十年来，尿动力学研究（UDS）的数量一直在稳步下降，然而，这一趋势背后的原因仍然知之甚少。本研究旨在调查泌尿外科UDS的结构方面，并探讨导致这种下降的因素。
方法：我们在2023年调查了所有执行UDS的泌尿科以及德国私人诊所的代表性样本。我们检查了结构情况，等待时间,UDS的容量和局限性。所有侵入性尿动力学检查均定义为UDS。
结果：2019年，德国259/474（55％）泌尿科进行了UDS。206/259(80%)泌尿科对调查做出了回应。163/200(82%)泌尿科表示他们的能力已经耗尽，主要原因是缺乏医疗和护理人员。54.8％的泌尿科为转诊医师执行了50％以上的UDS。UDS/年数量低（≤100）的泌尿科显示出更短的等待时间（最多4周：49％vs.30%；p=0.01），减少UDS容量(55%与12%；p<0.001)，这些容量通常没有得到充分利用(25%与9%；p=0.007）。122/280(44%)办公室泌尿科医生对调查做出了回应。18/122（15%）办公室泌尿科医师进行了UDS。不提供UDS的主要原因是缺乏人员和报销费用低。
结论：在德国泌尿科，UDS能力始终得到充分利用，主要是由于人员短缺。这种集中化的趋势引发了人们对UDS在泌尿科医师培训中的作用的质疑。
方法：我们在2023年调查了所有执行UDS的泌尿科以及德国私人诊所的代表性样本。我们检查了结构情况，等待时间,UDS的容量和局限性。所有侵入性尿动力学检查均定义为UDS。
结果：2019年，德国259/474（55％）泌尿科进行了UDS。206/259(80%)泌尿科对调查做出了回应。163/200(82%)泌尿科表示他们的能力已经耗尽，主要原因是缺乏医疗和护理人员。54.8％的泌尿科为转诊医师执行了50％以上的UDS。UDS/年数量低（≤100）的泌尿科显示出更短的等待时间（最多4周：49％vs.30%；p=0.01），减少UDS容量(55%与12%；p<0.001)，这些容量通常没有得到充分利用(25%与9%；p=0.007）。122/280(44%)办公室泌尿科医生对调查做出了回应。18/122（15%）办公室泌尿科医师进行了UDS。不提供UDS的主要原因是缺乏人员和报销费用低。
结论：在德国泌尿科，UDS能力始终得到充分利用，主要是由于人员短缺。这种集中化的趋势引发了人们对UDS在泌尿科医师培训中的作用的质疑。
