Comparison of ambulatory versus conventional urodynamics in females with urinary incontinence.

AIMS: We planned to compare the diagnostic accuracy of conventional urodynamics (UD) and ambulatory UD for the detection of detrusor over activity (DOA) and/or urodynamic stress incontinence (USI) in women presenting with urinary incontinence.
METHODS: We prospectively enrolled 44 women with urinary incontinence and performed both urodynamic (UD) studies after they completed the UDI-6 questionnaire. During ambulatory UD one micturition cycle was recorded. According to responses for individual items on the UDI-6, patients were divided into three groups to define incontinence type irrespective of scoring.
RESULTS: Mean age was 52.2 and mean duration of the symptoms was 4.94 years. The ambulatory UD detected an underlying pathophysiology of urinary incontinence (77.3%) in significantly more women than the conventional UD (6.8%) (P = 0.001). Among women with stress incontinence, 56% had USI on the ambulatory UD and none had abnormalities on the conventional UD (P = 0.002). Seventy-two percent of women with mixed symptoms had abnormal findings (USI and/or DOA) on the ambulatory UD and 9% had abnormal findings on the conventional UD (P = 0.001).
CONCLUSIONS: Our findings suggest that ambulatory UD done in a clinical setting during one micturition cycle with unstandardized provocative activities detects an underlying pathophysiology (urge incontinence, stress incontinence, mixed incontinence) more often than conventional UD in supine position Conventional UD has a higher false-negative rate in diagnosis of DOA and/or USI compared to ambulatory UD. (c) 2009 Wiley-Liss, Inc.