Maurizio Serati1, Luca Topazio2, Giorgio Bogani1, Elisabetta Costantini3, Amelia Pietropaolo4, Giovanni Palleschi5, Antonio Carbone5, Marco Soligo6, Giulio Del Popolo7, Vincenzo Li Marzi8, Stefano Salvatore9, Enrico Finazzi Agrò10. 1. Department of Obstetrics and Gynaecology, University Insubria, Varese, Italia. 2. School of Specialization in Urology, University Tor Vergata, Roma, Italia. 3. Department of Urology, University of Perugia, Perugia, Italia. 4. School of Specialization in Urology, University of Perugia, Perugia, Italia. 5. Department of Urology, University La Sapienza, Latina, Italia. 6. Department of Obstetrics and Gynaecology, Buzzi Hospital, Milano, Italia. 7. Spinal Unit, Careggi University Hospital, Firenze, Italia. 8. Department of Urology, Careggi University Hospital, Firenze, Italia. 9. Department of Obstetrics and Gynaecology, University Vita e Salute, Milano, Italia. 10. Department of Experimental Medicine and Surgery, University Tor Vergata, Roma, Italia.
Abstract
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.
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.
Authors: Andrea Cocci; Giovanni E Cacciamani; Giorgio Ivan Russo; Maria Angela Cerruto; Martina Milanesi; Luis G Medina; Sebastiano Cimino; Walter Artibani; Giuseppe Morgia; Marco Carini; Vincenzo Li Marzi Journal: Int Neurourol J Date: 2017-12-31 Impact factor: 2.835