The role of preoperative urodynamics in stress urinary incontinence surgery

Hickling, Duane; Steele, Stephen

doi:10.5489/cuaj.4581

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…Ineffective treatment of SUI cannot always be attributed to the procedure itself, but also to inappropriate choice of treatment in each particular case, even if the UI type is correctly established. In other studies it is also mentioned that the UDS do not have any clinical and economical value for isolated SUI prior to surgery, but we have to bear in mind that analysed patient group in these studies was isolated SUI [9,15,16]. At the same time, UDS is highly recommended at a recurrent UI after surgical treatment.…”

Section: Discussionmentioning

confidence: 95%

“…When considering the recommendations from different guidelines review for female patients with UI, it is clear that UDS can provide valuable additional information that is relevant to each individual, but important questions remain: At what stage of examination should UDS be performed, for which patients, and how can the results of UDS help to predict the outcomes of therapeutic interventions [8]? Two non-inferiority, multicentre, randomized, controlled trials demonstrate that preoperative UDS don't improve outcomes of SUI surgery [9]. At the same time, guidelines emphasize that UDS is indicated for patients with recurrent UI after surgery [1,8].…”

Section: Introductionmentioning

confidence: 99%

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Urodynamic Values Role For Females With Different Types Of Urinary Incontinence

Pilsetniece

Vjaters

2021

Russ Open Med J

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Aim — The aim of this study was to analyse how conventional urodynamic values differ between females with specific types of urinary incontinence (UI). Material and Methods — Cross-sectional study enrolled 666 females with UI. Based on patient history and questionnaires they were divided into three groups: stress (SUI), mixed (MixUI) and urgency (UUI). Physical investigation and urodynamics were performed. The continuous factors: age and urodynamic data were evaluated using Multinomial regression and ANOVA test using SUI, MixUI, UUI as outcome groups. Results — Analysing urodynamic parameters significant difference between at least two groups was shown by the cystometric capacity and maximum flow rate: both highest in the SUI group; residual urine, opening detrusor pressure, maximum urethral closure pressure at rest, functional urethral length at rest: all highest in the UUI group. Mainly all urodynamic data showed significant difference between SUI/UUI, and MixUI/UUI groups, while difference between SUI/MixUI were not significant. Conclusions — Most of urodynamic data for MixUI group patients do not differ from SUI group. UDS parameters like: maximum flow rate, residual urine, opening detrusor pressure, maximum urethral closure pressure at rest, functional urethral length at rest can help to distinguish SUI and MixUI groups from UUI group.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Urodynamic Values Role For Females With Different Types Of Urinary Incontinence

Pilsetniece

Vjaters

2021

Russ Open Med J

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“…UDS may be considered the most reliable test for achieving an objective preoperative evaluation of patients with SUI 5 , given that it allows to measure the leak point pressure (LPP), which in turn provides insight on the underlying mechanism 4 , 6 . However, even if theoretically the urodynamic study (UDS) optimizes the selection of cases and the choice of surgical procedures, to date there is no consensus on whether performing UDS results in better surgical outcomes 7 , 8 . Therefore, interest has been raised about the value of other tests to guide the diagnosis of ISD and/or to predict its surgical outcome.…”

Section: Introductionmentioning

confidence: 99%

Present value of the Urethral mobility test as a tool to assess Stress urinary incontinence due to Intrinsic sphincteric deficiency

Robledo

Zuluaga

Bravo‐Balado

et al. 2020

Sci Rep

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Q-tip test offers a simple approach for identifying urethral hypermobility. Considering surgical treatment, stress urinary incontinence (SUI) must be classified and the contribution of intrinsic sphincter deficiency (ISD) and/or urethral hypermobility must be determine. We believe there's a correlation between abdominal leak point pressure (ALPP) and urethral mobility degree, and the aim of this study is to explore it using Q-tip. We conducted a prospective study, between years 2014 and 2016. Females over 18 years presenting with signs and symptoms of SUI according to the 2002 ICS Standardization of Terminology were included. Assessment was made with the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), the Q-tip test and invasive urodynamics. Urethral mobility (UM) and ALPP were analyzed. We built two composite variables based on reported risk factors for ISD, defined as composite variable A (equal to a Q-tip test < 30° AND ICIQ-SF ≥ 10 points) and composite variable B (equal to low urethral mobility AND/OR hypoestrogenism AND/OR history of radiotherapy AND/OR previous pelvic surgery). Correlation analyzes were made according to the type of variable. A total of 221 patients were included. Incontinence was rated as moderate and severe by 65.3% and 6.8%, respectively. The analysis showed a 61.75%, 51.61% and 70.6% agreement between ALPP and UM, ALPP and composite variable A and ALPP and composite variable B respectively. Correlation and concordances were low (r = 0.155, r_s = − 0.053 and r_s = − 0.008), (rho_c = 0.036, k = 0.116 and k = 0.016). Neither the degree of UM, nor the composite variables, correlate or agree with urethral function tests in UDS, suggesting that the ALPP cannot be predicted using the Q-tip test or the ICIQ-SF for classifying patients with SUI.

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“…It is inappropriate to recommend pelvic floor muscle exercises without testing, because only 30% of women can contract this muscle group correctly [14,15]. In the diagnostics of the lower urinary tract, laboratory tests and urodynamic tests are also used [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…There are many methods available for treating urinary incontinence [16,19]. The treatment of urinary incontinence in women is an interdisciplinary problem [20].…”

Section: Introductionmentioning

confidence: 99%