title: Urodynamics useless before surgery for female stress urinary incontinence: Are you sure? Results from a multicenter single nation database.
abstract: The role of urodynamics (UDS) before surgery for stress urinary incontinence (SUI) remains a debated issue in female urology as well as in urogynaecology and it has been recently questioned on the basis of data coming from selected population of patients defined as "uncomplicated." The aim of this study was to investigate the percentage of "uncomplicated" patients undergoing urodynamic evaluations in six referral Italian centers. The secondary aim was to assess the prevalence of women, for whom the urodynamic evaluation could add new information to the pre-urodynamic picture and in how many cases these findings had a significant impact on patient management.
  
  
  
  The data of women who underwent urodynamic evaluation prior to surgery for stress urinary incontinence between 2008 and 2013 were retrospectively analyzed. According to the definition of the Value of Urodynamic Evaluation (ValUE) trial criteria, patients presenting with SUI were classified as "uncomplicated" or "complicated." Urodynamic observations were then compared with pre-urodynamic data.
  
  
  
  Overall, 2,053 female patients were considered. Only 740/2,053 (36.0%) patients were defined "uncomplicated" according to the definition used in the ValUE trial. The urodynamic observations were not consistent with the pre-urodynamic diagnosis in 1,276 out of 2,053 patients (62.2%). Voiding dysfunctions were urodynamically diagnosed in 394 patients (19.2%). Planned surgery was cancelled or modified in 304 patients (19.2%), due to urodynamic findings.
  
  
  
  "Uncomplicated" patients represent a minority among female SUI patients evaluated before surgery. In "complicated" patients, the role of urodynamic has not been challenged yet and UDS seems still mandatory. Neurourol. Urodynam. 35:809-812, 2016. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Obstetrics and Gynaecology, University Insubria, Varese, Italia.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Serati
authors.affiliation: School of Specialization in Urology, University Tor Vergata, Roma, Italia.
authors.forename: Luca
authors.initials: L
authors.lastname: Topazio
authors.affiliation: Department of Obstetrics and Gynaecology, University Insubria, Varese, Italia.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bogani
authors.affiliation: Department of Urology, University of Perugia, Perugia, Italia.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Costantini
authors.affiliation: School of Specialization in Urology, University of Perugia, Perugia, Italia.
authors.forename: Amelia
authors.initials: A
authors.lastname: Pietropaolo
authors.affiliation: Department of Urology, University La Sapienza, Latina, Italia.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palleschi
authors.affiliation: Department of Urology, University La Sapienza, Latina, Italia.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carbone
authors.affiliation: Department of Obstetrics and Gynaecology, Buzzi Hospital, Milano, Italia.
authors.forename: Marco
authors.initials: M
authors.lastname: Soligo
authors.affiliation: Spinal Unit, Careggi University Hospital, Firenze, Italia.
authors.forename: Giulio
authors.initials: G
authors.lastname: Del Popolo
authors.affiliation: Department of Urology, Careggi University Hospital, Firenze, Italia.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Li Marzi
authors.affiliation: Department of Obstetrics and Gynaecology, University Vita e Salute, Milano, Italia.
authors.forename: Stefano
authors.initials: S
authors.lastname: Salvatore
authors.affiliation: Department of Experimental Medicine and Surgery, University Tor Vergata, Roma, Italia.
authors.forename: Enrico
authors.initials: E
authors.lastname: Finazzi Agrò
mesh_terms: D000368:Aged; D016208:Databases, Factual; D003950:Diagnostic Techniques, Urological; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology*; D013520:Urologic Surgical Procedures
keywords: mid-urethral sling; stress urinary incontinence (SUI); urodynamic; urodynamic stress incontinence (USI)