A review of the concordance of diagnoses made after multi-channel urodynamics and video urodynamics in women with urinary incontinence.
OBJECTIVE
Symptoms of urinary incontinence often do not correlate well with the diagnosis provided by urodynamic investigations. Video urodynamics has been described as the "gold standard" investigation for patients with lower urinary tract symptoms. The aim of our study was to determine the concordance of diagnoses made on multi-channel and video urodynamics in women presenting with urinary incontinence to a tertiary care urogynaecology unit.


METHODS
We performed a retrospective chart review of 38 women who had video urodynamics and a multi-channel study completed within a one-year period. All patients had a complete history and pelvic floor assessment. The investigators completing each study were blinded to the clinical diagnoses, the physical findings, and the other urodynamics diagnoses. International Continence Society standards were followed for completion of all urodynamics investigations. Multi-channel studies were completed with the patient lying supine and video studies were performed with the patient sitting on a commode. The level of agreement of the diagnoses was calculated using a kappa (kappa) statistic with 95% confidence intervals (CI).


RESULTS
The median age of subjects was 61 years (range 14-79), with a median duration of lower urinary tract symptoms of 6.0 years (range 0.5-41). Patients had had a median of two previous bladder surgeries (range 0-5). The level of concordance of the two diagnoses gave a kappa of 0.16 (95% CI 0.06-0.26).


CONCLUSIONS
There was poor concordance between the diagnoses made on multi-channel and video urodynamics when the two tests were performed on the same patient. Prospective studies are required to evaluate the reproducibility of diagnoses made on cystometry.
Schulz
Jane A
JA
Department of Obstetrics and Gynecology, University of Alberta, Edmonton AB.
Smith
Kevin M
KM
Drutz
Harold P
HP