Urodynamics in the management of female stress incontinence--which test and when?
OBJECTIVE
This article reviews the literature from the last 12 months in the context of our existing knowledge base and reviews the contentious issue of the role of preoperative urodynamics for stress urinary incontinence, with particular reference to the choice of urodynamic investigations for diagnostic differentiation between intrinsic sphincter deficiency and urethral hypermobility, assessing symptom severity and predicting postoperative prognosis.


RESULTS
While there are significant conflicting data regarding the role of urodynamics, particularly in the functional assessment of the urethra, it is clear that these diagnostic techniques can provide clinically useful data. It is in this context that recent guidelines advising on restricted use of invasive urodynamics preoperatively should be carefully reviewed.


CONCLUSIONS
There is a pressing need for randomized controlled trials to be performed to fully assess the role of urodynamics in the preoperative assessment of stress urinary incontinence, especially at this time of rapid change in the surgical treatments available.
Department of Urology Research, Sheffield Teaching Hospitals NHS Trust, Royal Hallamshire Hospital, Sheffield, UK.
Anand K
AK
Patel
Christopher R
CR
Chapple
D003950:Diagnostic Techniques, Urological; D005260:Female; D006801:Humans; D015995:Prevalence; D012212:Rheology; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D014563:Urodynamics