Kasey Roberts1, Anood Alfahmy2, Diana Mitchell3, Stacy Kamumbu4, Audry Sebikali-Potts4, David Sheyn2. 1. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. Kasey.roberts@UHhospitals.org. 2. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. 3. Division of Female Pelvic Medicine and Reconstructive Surgery, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 4. Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Abstract
INTRODUCTION AND HYPOTHESIS: Pre-procedure urinalysis may add unnecessary cost and inconvenience for patients undergoing urodynamics. The hypothesis of this study was that urinalysis would perform poorly when predicting complications following urodynamics. METHODS: Case-control study of women aged 18-89 undergoing urodynamics from 01 January2008 to 31 December 2017 at two tertiary medical centers. Data collected included patient demographics, past medical history, lower urinary tract symptoms, urodynamics indication, urodynamics results, urinalysis result, antibiotic administration, and adverse events within 30 days. Wilcoxon rank-sum test was used to compare those with and without an adverse event. Logistic regression was performed using statistically significant variables on pairwise analysis. RESULTS: A total of 601 patients met the criteria; 11 of these experienced an adverse event, of which all were a urinary tract infection. There were no differences in the frequency of adverse events based on any urinalysis result, regardless of whether the patient received antibiotics. On pairwise analysis, variables associated with a higher frequency of adverse events were higher parity (3.5 (2-5) vs 2 (2, 3), p=0.038) and complaint of suprapubic pain (1 (9.1%) vs 4 (0.7%), p=0.002). On logistic regression, significant variables included increasing age (adjusted odds ratio [aOR] 1.03 per year (95% CI 1.03-4.06); p=0.002), any prolapse (aOR 6.45 (95% CI 3.60-11.54); p<0.001), pelvic organ prolapse as the indication for urodynamics (aOR 7.27 (95% CI 2.60-20.36); p<0.001), and a diagnosis of stress urinary incontinence (4.98 (95% CI 1.95-12.67); p<0.001). CONCLUSION: The frequency of adverse events after urodynamics is low, and urinalysis in asymptomatic patients does not seem to be useful in predicting morbidity.
INTRODUCTION AND HYPOTHESIS: Pre-procedure urinalysis may add unnecessary cost and inconvenience for patients undergoing urodynamics. The hypothesis of this study was that urinalysis would perform poorly when predicting complications following urodynamics. METHODS: Case-control study of women aged 18-89 undergoing urodynamics from 01 January2008 to 31 December 2017 at two tertiary medical centers. Data collected included patient demographics, past medical history, lower urinary tract symptoms, urodynamics indication, urodynamics results, urinalysis result, antibiotic administration, and adverse events within 30 days. Wilcoxon rank-sum test was used to compare those with and without an adverse event. Logistic regression was performed using statistically significant variables on pairwise analysis. RESULTS: A total of 601 patients met the criteria; 11 of these experienced an adverse event, of which all were a urinary tract infection. There were no differences in the frequency of adverse events based on any urinalysis result, regardless of whether the patient received antibiotics. On pairwise analysis, variables associated with a higher frequency of adverse events were higher parity (3.5 (2-5) vs 2 (2, 3), p=0.038) and complaint of suprapubic pain (1 (9.1%) vs 4 (0.7%), p=0.002). On logistic regression, significant variables included increasing age (adjusted odds ratio [aOR] 1.03 per year (95% CI 1.03-4.06); p=0.002), any prolapse (aOR 6.45 (95% CI 3.60-11.54); p<0.001), pelvic organ prolapse as the indication for urodynamics (aOR 7.27 (95% CI 2.60-20.36); p<0.001), and a diagnosis of stress urinary incontinence (4.98 (95% CI 1.95-12.67); p<0.001). CONCLUSION: The frequency of adverse events after urodynamics is low, and urinalysis in asymptomatic patients does not seem to be useful in predicting morbidity.
Authors: Mônica Martins Nóbrega; Antonio Pedro Flores Auge; Luis Gustavo Morato de Toledo; Sílvia da Silva Carramão; Armando Brites Frade; Mauro José Costa Salles Journal: Am J Infect Control Date: 2015-07-06 Impact factor: 2.918
Authors: Anne P Cameron; Lysanne Campeau; Benjamin M Brucker; J Quentin Clemens; Gregory T Bales; Michael E Albo; Michael J Kennelly Journal: Neurourol Urodyn Date: 2017-03-27 Impact factor: 2.696