The relationship between pre-procedure anxiety and bladder volume findings in adult urodynamic studies

Background and Objectives Urodynamic Studies (UDS) are essential for evaluating lower urinary tract dysfunction; however, the invasive nature of the procedure may induce patient anxiety and artificially alter physiological findings. This study investigates the influence of pre-procedural somatic and cognitive anxiety on bladder volume parameters compared to real-world capacity documented in home bladder diaries. Methods We conducted a prospective cross-sectional analysis of 34 adult patients undergoing UDS. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI-Y) for cognitive anxiety and the Beck Anxiety Inventory (BAI) for somatic anxiety, administered before and after the procedure. Bladder capacity measured during UDS was compared with maximum voided volumes recorded in a 3-day home bladder diary using the Wilcoxon signed-rank test. Key Findings and Limitations Cognitive state anxiety remained stable and low throughout the clinical encounter. Somatic anxiety was moderate at baseline (BAI median: 16.00; range: 6.00–38.00) and showed a clinically meaningful post-procedural reduction (median: 12.00; range: 3.00–34.00; p = 0.001). A significant discrepancy was identified between home bladder diary capacity (median: 280.00 mL) and UDS-measured capacity (median: 225.00 mL), representing a median deficit of −50.00 mL (p < 0.001). Limitations include a single-centre design and modest sample size. Conclusions and Clinical Implications Somatic anxiety was the predominant factor associated with reduced functional bladder capacity during UDS. Clinicians should integrate 3-day home bladder diaries into the diagnostic process to ensure treatment plans reflect real-world storage dynamics rather than procedure-related physiological responses.