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Standardization and Reproducibility in Multicentre Urodynamic Trials

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Abstract

Purpose of review

Urodynamic studies (UDS) remain the gold standard for the objective evaluation of lower urinary tract dysfunction, yet their diagnostic precision is frequently compromised by technical inconsistencies, interobserver variability, and methodological flaws in multicentre trials. This review maps these sources of variability and outlines strategies to restore reproducibility.

Recent findings

Variability spans technical acquisition errors, inconsistent patient coaching and terminology, interpretive subjectivity in trace reading, and trial-design flaws such as restrictive selection criteria and oversimplified diagnostic classification. Empirical surveys reveal marked heterogeneity in clinical practice across centres. Emerging solutions include structured quality assurance frameworks, standardized communication protocols, wireless catheter-free pressure sensors, and artificial intelligence pipelines achieving diagnostic accuracies of 80–95% for pattern recognition, though external validation and reference-standard circularity remain unresolved challenges.

Summary

Addressing these vulnerabilities through harmonized protocols, objective communication tools, centralized trace review, and validated AI support is essential to restore the credibility of urodynamic research and ensure tailored, evidence-based patient management.

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Data Availability

No datasets were generated or analysed during the current study.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Surgical Sciences, AOU Policlinico Tor Vergata, Rome, 00181, Italy

    Eleonora Rosato & Enrico Finazzi Agrò

  2. Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, 00181, Italy

    Eleonora Rosato & Enrico Finazzi Agrò

Authors
  1. Eleonora Rosato
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  2. Enrico Finazzi Agrò
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by both authors. The first draft of the manuscript was written by Eleonora Rosato and Enrico Finazzi Agrò commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Eleonora Rosato.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Financial interests

Author Eleonora Rosato declare they have no financial interests.

Competing interests

Author Enrico Finazzi Agrò receives speaker honoraria from Recordati and Pierre Fabre and serves as a consultant and receives honoraria for speaking from Laborie.

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Rosato, E., Finazzi Agrò, E. Standardization and Reproducibility in Multicentre Urodynamic Trials. Curr Bladder Dysfunct Rep 21, 40 (2026). https://doi.org/10.1007/s11884-026-00841-w

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