The Value of Urodynamic Testing in Stress Urinary Incontinence

Abstract

Preoperative urodynamic testing for the identification of specific types of urinary incontinence was found useful to select an appropriate operative procedure. Failure of the operation to relieve stress incontinence was unusual in 346 patients followed for a minimum of 2 years. Of the total group of patients with stress incontinence 27 per cent also had detrusor instability identified urodynamically preoperatively. However, identification of the syndrome is of limited prognostic significance since the majority of these patients had no difficulty with the syndrome postoperatively and some other patients appeared to have the syndrome only postoperatively.

Comparative Analysis of Bladder Neck Suspension Using Raz, Burch and Transvaginal Burch Procedures

“…Genuine stress urinary incontinence (SUI) is a pathologic condition presenting as involuntary urinary loss that can be objectively identified as the product of an abdominal pressure expulsive force, which is distinct from the pressure originating from the detrusor musculature or bladder wall resistance to the urinary bolus [1]. The prevalence of pure SUI was reported to range from 26.7 [2] to 40% [3].…”

Do women with pure stress urinary incontinence need urodynamics?

“…This topic is not new as evidenced by past papers on same by thought leaders such as McGuire et al three decades ago (1). It is noteworthy to see that the rate of patients with detrusor overactivity from the reviewed paper and that quoted from the paper by McGuire et al is almost identical (1). The debate on the evaluation of the incontinent patient may be expanded to multi-channel fluoroscopic urodynamics studies versus clinical acumen combined with eyeball urodynamics.…”

Leak point pressure at different bladder volumes in stress urinary incontinence in women: Comparison between Valsalva and coughinduced leak point pressure

“…[4][5][6]10 McGuire et al introduced the concept of type III incontinence, the most severe form of incontinence of ISD. 16 They noted that some patients show repeated failure from the retropubic suspension surgery for the correction of SUI and described that patients with failed surgery had a deficient urethral sphincter function characterized by open bladder neck and proximal urethra at rest with minimal or no urethral movement during increased intra-abdominal pressure. 16 It has been considered that surgical procedures for the correction of SUI with ISD component have a somewhat high incidence of failure rate because of the underlying problem of severe urethral dysfunction.…”

“…16 They noted that some patients show repeated failure from the retropubic suspension surgery for the correction of SUI and described that patients with failed surgery had a deficient urethral sphincter function characterized by open bladder neck and proximal urethra at rest with minimal or no urethral movement during increased intra-abdominal pressure. 16 It has been considered that surgical procedures for the correction of SUI with ISD component have a somewhat high incidence of failure rate because of the underlying problem of severe urethral dysfunction. In the setting of the urologic clinic, whether the patient with SUI has ISD or not is an important clinical factor, especially before making a surgical decision, because it can change the operative outcome.…”