Value of Preop Urodynamics for SUI Questioned

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New findings from a small study raise questions about the value of performing preoperative urodynamic investigations in women with stress urinary incontinence (SUI).

The findings are from a study of 59 women with SUI randomly assigned to a preoperative workup with urodynamics (31 patients) or without (28 patients). The primary outcome was clinical reduction in the number of complaints as measured using the Urogenital Distress Inventory urinary incontinence subscale (UDI-UI) at 12 months after treatment.

Investigators led by Sanne van Leijsen, MD, of Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands, found that the mean difference in improvement on the UDI-UI favored the group without urodynamic studies, confirming that the omission of urodynamics was not inferior to the use of urodynamics in the preoperative workup of women with SUI.

The two groups had similar rates of objective cure: 93% and 92% of the patients with and without urodynamics, respectively, had a negative stress test.

Moreover, the addition of urodynamics did not result in a lower occurrence of de novo overactive bladder complains compared to a workup without urodynamics, the researchers reported online ahead of print in Neurourology and Urodynamics. In the urodynamics group, initial surgical management was more often abandoned compared with the group that had did not have urodynamic studies.

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