title: Do urodynamic parameters predict persistent postoperative stress incontinence after midurethral sling? A systematic review.
abstract: OBJECTIVE
  It is unclear whether preoperative urodynamic study (UDS) values are predictive of outcomes after midurethral sling.
  
  
  METHODS
  We systematically reviewed multiple databases from January 1989 to October 2011 for English-language studies correlating UDS data with postoperative outcomes after midurethral slings. We performed random effects model meta-analyses, as indicated. Relative risk (RR) ratios for the outcome of stress urinary incontinence (SUI) cure were calculated using high maximum urethral closure pressure (MUCP) and Valsalva leak point pressure (VLPP) values as the reference group.
  
  
  RESULTS
  High preoperative MUCP was associated with cure after retropubic [RR 0.67; 95% confidence interval (CI) 0.47-0.97)] and transobturator slings (RR 0.65; 95% CI 0.49-0.90). High preoperative VLPP was also associated with cure after retropubic sling (RR 0.89; 95% CI 0.82-0.96), but this relationship did not achieve statistical significance for cure after transobturator sling (RR 0.86; 95% CI 0.74-1.00).
  
  
  CONCLUSIONS
  Preoperative MUCP and VLPP values may add insight into postoperative outcomes after surgical treatment for SUI.
authors.affiliation: Department of Obstetrics & Gynecology, Division of Urogynecology, Duke University Medical Center, 5324 McFarland Drive, Suite 310, Durham, NC 27707, USA. amie.kawasaki@duke.edu
authors.forename: Amie
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Wu
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Amundsen
authors.forename: Alison C
authors.initials: AC
authors.lastname: Weidner
authors.forename: John P
authors.initials: JP
authors.lastname: Judd
authors.forename: Ethan M
authors.initials: EM
authors.lastname: Balk
authors.forename: Nazema Y
authors.initials: NY
authors.lastname: Siddiqui
mesh_terms: D005260:Female; D006801:Humans; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D011312:Pressure; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000601:surgery*; D014563:Urodynamics