Urodynamics Influence OAB Treatment Decisions
Clinicians’ choice of treatment highly correlated with a diagnosis based on urodynamic studies.
For women with overactive bladder (OAB) or urgency-predominant urinary incontinence, treatment based on urodynamic studies (UDS) versus symptoms may result in better outcomes, new research findings suggest.
Tina Sara Verghese, MBBS, and her colleagues from the University of Birmingham in the United Kingdom recruited 687 women with overactive bladder (OAB), of whom 69% underwent UDS. According to results published in the International Urogynecology Journal (2018;29:513–519), management decisions highly correlated with UDS-based diagnosis, including detrusor overactivity (DO), urodynamic stress incontinence (USI), DO plus USI, or normal. Women with DO, for example, were 3 times more likely to receive bladder relaxants than no treatment. Women diagnosed with DO plus USI were 15 times more likely to have USI surgery.
Furthermore, more women treated according to a UDS-based diagnosis reported improvement in symptoms at 20 months than those managed based on history and clinical examination (57% vs 45%). The investigators found that scores declined slightly more for these women (0.5 points) on the International Consultation on Incontinence OAB Short Form.
“We believe that these data will hopefully offer some evidence to the clinical community that UDS does change patient management in current clinical practice,” Dr Verghese's team stated. The team is planning a multicenter randomized controlled trial to corroborate findings in women with OAB. “This will help to consolidate the role of UDS in the management of these women, as has been done for stress urinary incontinence.”
Verghese TS, Middleton LJ, Daniels JP, Deeks JJ, and Latthe PM. The impact of urodynamics on treatment and outcomes in women with an overactive bladder: a longitudinal prospective follow-up study. Int Urogynecol J 2018;29:513–519. DOI 10.1007/s00192-017-3414-4