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Urodynamics useless before surgery for female stress urinary incontinence: Are you sure? Results from a multicenter single nation database
Author(s) -
Serati Maurizio,
Topazio Luca,
Bogani Giorgio,
Costantini Elisabetta,
Pietropaolo Amelia,
Palleschi Giovanni,
Carbone Antonio,
Soligo Marco,
Del Popolo Giulio,
Li Marzi Vincenzo,
Salvatore Stefano,
Finazzi Agrò Enrico
Publication year - 2016
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22804
Subject(s) - medicine , urodynamic testing , urinary incontinence , urodynamic studies , referral , stress incontinence , urology , urinary system , gynecology , family medicine
Aims The role of urodynamics (UDS) before surgery for stress urinary incontinence (SUI) remains a debated issue in female urology as well as in urogynaecology and it has been recently questioned on the basis of data coming from selected population of patients defined as “uncomplicated.” The aim of this study was to investigate the percentage of “uncomplicated” patients undergoing urodynamic evaluations in six referral Italian centers. The secondary aim was to assess the prevalence of women, for whom the urodynamic evaluation could add new information to the pre‐urodynamic picture and in how many cases these findings had a significant impact on patient management. Methods The data of women who underwent urodynamic evaluation prior to surgery for stress urinary incontinence between 2008 and 2013 were retrospectively analyzed. According to the definition of the Value of Urodynamic Evaluation (ValUE) trial criteria, patients presenting with SUI were classified as “uncomplicated” or “complicated.” Urodynamic observations were then compared with pre‐urodynamic data. Results Overall, 2,053 female patients were considered. Only 740/2,053 (36.0%) patients were defined “uncomplicated” according to the definition used in the ValUE trial. The urodynamic observations were not consistent with the pre‐urodynamic diagnosis in 1,276 out of 2,053 patients (62.2%). Voiding dysfunctions were urodynamically diagnosed in 394 patients (19.2%). Planned surgery was cancelled or modified in 304 patients (19.2%), due to urodynamic findings. Conclusions “Uncomplicated” patients represent a minority among female SUI patients evaluated before surgery. In “complicated” patients, the role of urodynamic has not been challenged yet and UDS seems still mandatory. Neurourol. Urodynam. 35:809–812, 2016 . © 2015 Wiley Periodicals, Inc.