(Poster 14) Risk Factors for Same-Day Cancellation of Urodynamic Testing

Objectives: To evaluate risk factors for urodynamic testing cancellation by comparing patient characteristics of those who underwent successful urodynamic (UDS) testing to those whose testing was not performed, due to suspected urinary tract infection (UTI) on the day of testing or because the patient missed their appointment.

Methods: This was an IRB-approved retrospective cohort study of patients who were scheduled for UDS at a single institution between August 1, 2022 and April 30, 2024, inclusive. Demographic information, medical history, physical exam findings, PFDI-20 responses, and urodynamic results were collected. Patients who experienced same-day cancellation for either suspected UTI or due to missing the appointment were compared to patients who successfully completed UDS.

Results: In total, 657 charts were identified; 579 (88.1%) completed UDS and 78 (11.9%) had same-day cancellation. Comparing patients who completed UDS to patients who had same-day cancellation, the latter group had a higher BMI (31.6 ± 8.0 vs 29.6 ± 6.6 kg/m2, p=0.031) and a higher prevalence of Hispanic patients (11.0% vs 24.4%, p< 0.001) (Figure 1). Reasons for same-day cancellation included 32 patients who missed their appointment, 42 who cancelled for suspected UTI, and 4 who cancelled for other reasons. When compared to patients who completed UDS, patients who cancelled for suspected UTI were older (73.0 ± 12.6 vs 62.9 ± 13.4, p< 0.001), more likely to have diabetes (26.2% vs 14.8%, p=0.049), and to have a history of recurrent UTI (19.0% vs 9.5%, p=0.047). Patients in the ‘missed appointment’ group were younger (56.0 ± 12.9 vs 62.8 ± 13.4, p=0.005), had a higher BMI (32.9 ± 7.9 vs 29.6 ± 6.6, p=0.007), were less likely to be White (56.3% vs 79.3%), more likely to be Hispanic (34.4% vs 11.0%, p< 0.001), less likely to be menopausal (53.1% vs 76.6%, p=0.010), and more likely to be on an overactive bladder medication (33% vs 61.6%, p=0.037) (Figure 2). Prolapse severity, PFDI score, and indication for UDS did not differ statistically between groups.

Conclusions: Patients who experience same-day cancellation of UDS due to missing their appointment and for suspected UTI have unique characteristics. Patients who are older, have a history of diabetes, or recurrent UTIs are more likely to be cancelled for suspected UTI. This finding presents an opportunity for identifying patients who would benefit from pre-procedure antibiotic prophylaxis. Patients who miss their appointment have demographic factors indicating possible socioeconomic barriers for UDS testing. Efforts should be made to further understand and minimize these barriers.