When to perform urodynamics before mid-urethral sling  surgery for female stress urinary incontinence?
OBJECTIVE
Development of a model that can predict in which group of women pre-operative urodynamics can be safely omitted.


METHODS
Three hundred and eighty-one uncomplicated women who underwent pre-operative urodynamics were evaluated. A multivariate logistic regression model was developed based on medical history and physical examination predicting a high probability group of women with detrusor overactivity or a low (<20 cm H2O) mean urethral closure pressure and, therefore, are likely to benefit from urodynamics.


RESULTS
Women are likely to benefit from pre-operative urodynamics if they (1) are 53 years of age or older or (2) have a history of prior incontinence surgery and are at least 29 years of age or (3) have nocturia complaints and are at least 36 years of age.


CONCLUSIONS
If urogynaecologists omitted pre-operative urodynamics in women in the low probability group, in our population, pre-operative urodynamics would be reduced by 29%.
Houwert
R Marijn
RM
Department of Obstetrics and Gynecology, St. Elisabeth Hospital Tilburg, Rooseveltlaan 35 III, 1079 AC Amsterdam, The Netherlands. marijnhouwert@hotmail.com
Roovers
Jan Paul W R
JP
Venema
Pieter L
PL
Bruinse
Hein W
HW
Dijkgraaf
Marcel G W
MG
Vervest
Harry A M
HA
D000328:Adult; D000368:Aged; D000075202:Contraindications; D003661:Decision Support Techniques; D003950:Diagnostic Techniques, Urological / Q000706:statistics & numerical data*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D011300:Preoperative Care; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000601:surgery; D014563:Urodynamics