The role of urodynamics in females with lower urinary tract symptoms

Mousa, Riyad T. Al; Dossary, Nader Al; Hashim, Hashim

doi:10.1080/2090598x.2019.1589931

Cited by 13 publications

(22 citation statements)

References 58 publications

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“…In our study, the prevalence of OSUI was 23.5% when using urodynamics with prolapse reduction, which is equal to that reported in the literature of 23.5% 23 . As was demonstrated in the recent review, urodynamic studies remain a valuable diagnostic test, providing vital information to both the surgeon and patient prior to invasive treatment, with minimal morbidity 24 . In our study, we found 105 patients had OSUI, and 33 patients underwent a concomitant incontinence procedure at the time of prolapse repair.…”

Section: Discussionmentioning

confidence: 95%

The Value of Preoperative Urodynamics in Surgery Decision for Pelvic Organ Prolapse Patients with Occult Stress Urinary Incontinence

Xia

et al. 2020

Preprint

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This retrospective cohort study aims to explore the clinical value of urodynamics in evaluating lower urinary tract function in pelvic organ prolapse (POP) patients, and to investigate the urodynamic characteristics of POP patients with occult stress urinary incontinence (OSUI) in whom moderate or above postoperative SUI eventually occurred after prolapse surgery. The medical records of 626 advanced POP patients who underwent vaginal pelvic reconstructive surgery were analyzed. The patients with anterior compartment prolapse were more susceptible to urodynamic changes than those with apical or posterior compartment prolapse (95.1% vs. 40.15%). The proportion of patients with urodynamic abnormality was increased with prolapse severity (68.8% vs. 78.6%). After 3 months, the incidence of moderate or severe postoperative urinary incontinence in the OSUI patients was 20%, while it is 2.8% in non-OSUI patients. In subgroup analysis of OSUI patients, the urodynamics of patients with moderate or above postoperative urinary leakage showed significantly lower Valsalva leak point pressure (VLPP), maximum urethral closure pressure (MUCP), maximal bladder volume (MBV) and maximum urine flow rate (MUFR). For POP patients with OSUI, anti-incontinence surgery is only recommended for whom with lower VLPP, MUCP, MBV and MUFR to avoid the risk and costs of secondary surgery or overtreatment.

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Section: Discussionmentioning

confidence: 95%

The Value of Preoperative Urodynamics in Surgery Decision for Pelvic Organ Prolapse Patients with Occult Stress Urinary Incontinence

Xia

et al. 2020

Preprint

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“…Indeed, how can we be sure that pure SUI is indeed ‘pure’? A study by Digesu analysed the data of 3428 women with SUI and concluded that “only 8.9% of the patients were classified as having pure SUI… UDS provides useful information in the assessment of women with pure SUI” [ 10 ]. Also, McGuire emphasized individual differences between the patients with SUI and that the effectiveness of therapy directly depended on precise pathophysiological diagnosis, therefore UDS should be recommended for all female patients [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…The clinical significance of urodynamic variables (UDS) in uncomplicated SUI cases has been disputed even when surgical intervention is planned [ 1 – 6 ]. Some authors have asserted that UDS can provide essential clues about other types of lower urinary tract dysfunctions (LUTD), as well as the specific pathogenesis and severity of SUI, that may justify the inconvenience of UDS testing [ 5 , 7 – 10 ]. However, it is still important to determine the most informative UDS parameters for the purpose of predicting postoperative outcomes for SUI patients.…”

Section: Introductionmentioning

confidence: 99%

“…This was also the conclusion of the large randomised ValUE and VUSIS-II studies [ 11 , 12 ]. At the same time, there is no doubt about the benefit of UDS testing for women with recurrent or complicated SUI [ 10 ]. It is important to know that in the initial diagnostic algorithm, everything has been done to avoid complicated cases, and UDS can probably be of benefit for this purpose.…”

Section: Introductionmentioning

confidence: 99%

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Can conventional urodynamic variables help to predict the necessity of overactive bladder symptomatic therapy in women after transobturator tape surgery?

Pilsetniece

Vjaters

2020

Cent european J Urol

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Introduction The aim of this study was to find out if there are any conventional urodynamic (UDS) variables that would help to predict the necessity of overactive bladder (OAB) symptomatic therapy in women after transobturator tape surgery (TOT). Material and methods A total of 487 females after TOT were enrolled in this retrospective study. Inclusion criteria (UDS before surgery, follow-up visit within 2–6 month after TOT) were met in 169 women. Based on patient history, questionnaires and physical examination, two groups were distinguished: pure stress urinary incontinence (SUI) and stress-predominant mixed urinary incontinence (MixUI). A statistical analysis was performed including age and UDS variables. T-test was used for continuous data and Chi-squared test for categorical data. Combinations of these factors were analyzed using binary logistic regression and surgery outcome as the target variable. Results Significant correlations between the probability of a need for OAB therapy after TOT were observed with age (higher age increases OAB therapy necessity, p <0.001) and such UDS variables as cystometric capacity (CC) p <0.001; maximum flow rate (Qmax) p <0.001; detrusor contractility index (DCI) p <0.015 – higher value decreased the need for OAB therapy. Critical limit for these values: 60 years for age, 300 ml for CC, 15 ml/s for Qmax, but no specific value for DCI was observed. Binary logistic regression showed that the UI Group (p <0.01) and CC (p = 0.01) allow correctly classify 78.9% of TOT outcome (increased CC and SUI group are factors for TOT normal outcome). Conclusions UI group, age, CC, Qmax, DCI can help to predict the necessity of OAB symptomatic therapy in women after TOT.

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“…Although history and neurological examination provide evidence for complicated SUI, a detailed UDS such as VUDS is mandatory to identify women with SUI and DU, low bladder compliance, large cystocele, provoked DO, and bladder outlet dysfunction [31]. Recent literature review also indicates that UDS provides additional information regarding lower urinary tract function that could guide the physician to make the right therapeutic choice [32,33].…”

Section: Role Of Videourodynamic Study In the Management Of Stress Urinary Incontinencementioning

confidence: 99%

Role of videourodynamic study in precision diagnosis and treatment for lower urinary tract dysfunction

Jiang

Chen

2020

Tzu Chi Med J

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Lower urinary tract symptoms (LUTS) are complicated and cannot be used alone to diagnose lower urinary tract dysfunctions (LUTDs) and guide treatment. Patients with bladder outlet obstruction (BOO), impaired detrusor contractility, and hypersensitive bladder might present with voiding predominant symptoms, whereas patients with detrusor overactivity (DO), dysfunctional voiding, or BOO might also present with storage symptoms. To clearly identify the pathophysiology of LUTD, a comprehensive urodynamic study (UDS) including pressure flow and image during the storage and emptying phases, naming videourodynamic study (VUDS), is necessary. This study is especially mandatory in the diagnosis of (1) male LUTS refractory to medical treatment for benign prostatic hyperplasia, (2) female voiding dysfunction and urinary retention, (3) diagnosis of overactive bladder syndrome refractory to first-line medication, (4) management of female stress urinary incontinence and postoperative LUTS, (5) diagnosis and management of neurogenic LUTD, (6) pediatric urinary incontinence and enuresis, (7) geriatric urinary incontinence, and (8) recurrent bacterial cystitis. Although VUDS should not be used as a screening test for any LUTS, it should be considered when the initial management cannot relieve LUTS, or when invasive surgical procedure is planning to undertake for patients with refractory LUTS. VUDS should be recommended as the second-line investigation when the initial diagnosis and treatment based on the symptoms alone or noninvasive tests fail to improve LUTS.

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The role of urodynamics in females with lower urinary tract symptoms

Cited by 13 publications

References 58 publications

The Value of Preoperative Urodynamics in Surgery Decision for Pelvic Organ Prolapse Patients with Occult Stress Urinary Incontinence

The Value of Preoperative Urodynamics in Surgery Decision for Pelvic Organ Prolapse Patients with Occult Stress Urinary Incontinence

Can conventional urodynamic variables help to predict the necessity of overactive bladder symptomatic therapy in women after transobturator tape surgery?

Role of videourodynamic study in precision diagnosis and treatment for lower urinary tract dysfunction

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