International Consultation on Incontinence 2016; Executive summary: Urodynamic testing

Abstract

Aims The International Consultation on Incontinence has published an update of the recommendations for the diagnosis and management of urine incontinence (ICI2016). This manuscript summarizes the consultations committee—recommendations with regard to urodynamic assessment. Methods Expert consensus on the basis of structured evidence assessment has been the basis of the consultations publication and has been summarized by the committee for this manuscript. Results Patients that are not satisfied with their initial management on the basis of their reported signs and symptoms of urinary incontinence, as well as all patients with neurological abnormalities that are potentially relevant for the function of the lower urinary tract, may very likely profit from objective diagnosis and staging and grading of their dysfunction, with urodynamic testing, regardless their age, vulnerability and/or comorbidities. The principles and technical innovations as well as the principal recommendations for the utilization of (invasive) urodynamic assessment for women, men, children, and vulnerable elderly, with or without neurogenic lower urinary tract dysfunction with urinary incontinence are provided in this abbreviated ICI recommendations‐document. Conclusions The ICI2016 committee on urodynamics presents an executive summary of the most important reasons and recommendations for the use of urodynamic investigations for patients with urinary incontinence.

Can clinical and urodynamic parameters predict the occurrence of neutralizing antibodies in therapy failure of intradetrusor onabotulinumtoxin A injections in patients with spinal cord injury?

“…Urodynamic studies were performed according to International Continence Society standards [ 21 , 22 ] after the exclusion of UTI by urinalysis and culture. We evaluated the following two urodynamic parameters as essential criteria for a lack of effectiveness: maximum cystometric capacity (MCC, in the absence of sensation, the clinician decided to terminate filling in accordance with high detrusor filling pressure due to involuntary detrusor contraction/NDO) and maximum detrusor pressure (MDP) during filling cystometry [ 23 ].…”

ICS Educational Module: Cough stress test in the evaluation of female urinary incontinence: Introducing the ICS‐Uniform Cough Stress Test

“…The last being a urodynamic stress test and/or leak point pressure (LPP) determination. Practice and validity of (UDS‐)LPP testing are not further discussed but are summarized, for example, in the ICI‐consultation report …”

“…There is general consensus that the CST in combination with the SUI‐S is reliable in confirming that the pathophysiology of the UI is SUI . In a review of the literature to determine the predictive value of the clinical evaluation of SUI (history, physical exam with CST) using multichannel UDS as the comparator, it was found that for the diagnosis of genuine SUI, the CST alone had sensitivity (sens:) 57%, specificity (spec:) 71%, positive predictive value (PPV) of 55% and negative predictive value (NPV) of 73% .…”

Role of videourodynamic study in precision diagnosis and treatment for lower urinary tract dysfunction

“…Patients usually have persistent storage or voiding LUTS after the surgery. VUDS provides a clear differential diagnosis to differentiate the etiology of male LUTS and may avoid unnecessary operation or overtreatment [6]. Although men with storage predominant LUTS are likely to have bladder dysfunction rather than BOO, a certain percentage of men might have BOO-related overactive bladder (OAB).…”

“…UDS can be considered as an objective measure and documents the lower urinary tract functions and dysfunctions. The results of UDS can have therapeutic consequences and may change the management strategy of LUTD [6].…”