Use of urodynamics prior to surgery for urinary incontinence: How helpful is preoperative testing?
It has not yet been definitively demonstrated that preoperative evaluation of women with stress urinary incontinence with urodynamic testing enhances presurgical counseling, more effectively models patients' expectations or improves postoperative outcome. Nonetheless, urodynamic testing is frequently utilized in the assessment of women with stress urinary incontinence and clearly accomplishes a number of goals when utilized for this purpose. For example, there are data to suggest that the risk of voiding dysfunction can be mitigated by utilizing data obtained from urodynamic testing to identify women more likely to void ineffectively after conventional stress incontinence procedures. Furthermore, it has been suggested though not proven, that patients with more severe forms of stress incontinence as identified by urodynamic testing, might be less likely to improve after surgery compared to others with more modest degrees of incontinence. Since urodynamic testing is invasive, costly and not always available, it is imperative that the usefulness of such testing be carefully explored and its utility appropriately defined. In this review, we discuss urodynamic techniques to assess stress urinary incontinence, particularly focusing on the ability of leak point pressure testing and urethral pressure profilometry to predict which patients would most likely benefit from surgery and which might be more likely to experience adverse events following surgery.
Lemack
Gary E
GE
University of Texas Southwestern Medical Center, Dallas, TX, USA.
Eur Urol. 2005 Nov;48(5):805-9
16182440
BJOG. 2006 Jan;113(1):30-3
16398768
J Urol. 2006 May;175(5):1794-8; discussion 1798-9
16600764
J Urol. 1998 Oct;160(4):1312-6
9751343
Obstet Gynecol. 1987 Mar;69(3 Pt 1):399-402
3822288
J Urol. 1996 Jan;155(1):281-5
7490856
J Urol. 1999 Dec;162(6):2073-7
10569573
Neurourol Urodyn. 1998;17(2):121-7
9514144
BJOG. 2006 Jan;113(1):34-8
16398769
BJU Int. 2002 Mar;89(4):356-63
11872024
Neurourol Urodyn. 2004;23(2):109-14
14983420
Eur Urol. 2004 Feb;45(2):203-7
14734007
Obstet Gynecol Surv. 2001 Nov;56(11):720-35
11711907
Eur J Obstet Gynecol Reprod Biol. 2005 Dec 1;123(2):212-7
16024161
Int Urogynecol J Pelvic Floor Dysfunct. 2002 Nov;13(6):353-7; discussion 358
12466905
J Am Coll Surg. 2003 Apr;196(4):579-83
12691935
J Urol. 1993 Nov;150(5 Pt 1):1452-4
8411422
J Urol. 2006 Jul;176(1):186-8; discussion 188
16753397
Urology. 1990 Sep;36(3):245-8
2392816
J Urol. 2000 Jun;163(6):1845-8
10799196
J Urol. 1999 Aug;162(2):460-3
10411057
J Urol. 2004 Jul;172(1):210-4
15201776
Neurourol Urodyn. 2007;26(3):392-6
17304525
J Med Assoc Thai. 2005 Nov;88(11):1493-6
16471091
Am J Obstet Gynecol. 2000 Jan;182(1 Pt 1):30-4
10649153
J Urol. 2001 Dec;166(6):2259-62
11696747
Int Urogynecol J Pelvic Floor Dysfunct. 2000;11(5):285-9
11052563
Urology. 2000 Apr;55(4):506-11
10736492
Eur Urol. 1998;34 Suppl 1:13-5
9705547
Cochrane Database Syst Rev. 2002;(3):CD003195
12137680
Int Urogynecol J Pelvic Floor Dysfunct. 2001;12 Suppl 2:S5-8
11450979
J Urol. 1997 Mar;157(3):818-20
9072575
Urology. 1999 Sep;54(3):461-6
10475355
J Urol. 2000 Nov;164(5):1623-7
11025719
Eur Urol. 2003 Sep;44(3):372-6; discussion 376
12932939
J Urol. 2003 Jun;169(6):2234-7
12771757
J Urol. 2002 May;167(5):2093-7
11956447
Am J Obstet Gynecol. 1995 Aug;173(2):407-12; discussion 412-4
7645615
Am J Obstet Gynecol. 1999 Jul;181(1):12-8
10411835
Arch Gynecol Obstet. 2004 Mar;269(3):205-7
12942265
Obstet Gynecol. 1996 Jul;88(1):128-32
8684745
Gynecol Obstet Invest. 1989;27(3):155-9
2737549
J Urol. 1997 Sep;158(3 Pt 1):875-80
9258103
BJU Int. 2003 Apr;91(6):502-6
12656903
Am J Obstet Gynecol. 1997 Aug;177(2):262-6; discussion 266-7
9290438
Int Urogynecol J Pelvic Floor Dysfunct. 2003 Nov;14(5):339-41; discussion 341
14618312
Neurourol Urodyn. 2003;22(1):2-6
12478594
Int Urogynecol J Pelvic Floor Dysfunct. 2003 Oct;14(4):282-7; discussion 286-7
14530842