| December 2012 · Vol. 24, No. 12 EXAMINING THE EVIDENCE
Does urodynamic testing before
surgery for stress incontinence
improve outcomes?Not for straightforward stress urinary incontinence. This multicenter, randomized, noninferiority trial from the Urinary Incontinence Treatment Network found no significant differences in 1-year outcomes between women who underwent urodynamic testing versus those who did not.
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HAVE YOU READ THESE ARTICLES ON TREATING
URINARY PROBLEMS?
CLICK HERE to access 8 other articles about treating urinary incontinence and urinary tract infections, published in OBG Management in 2012.
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Nager CW, Brubaker L, Litman HJ, et al; Urinary Incontinence Treatment Network. A randomized trial of urodynamic testing before stress-incontinence surgery. N Engl J Med. 2012;366:1287–1297. EXPERT COMMENTARY
G. Willy Davila, MDChair, Department of Gynecology, and Head, Section of Urogynecology and Reconstructive Pelvic Surgery, Cleveland Clinic Florida, Weston, Florida.
Nager and colleagues conducted their trial to determine whether urodynamic testing is necessary before midurethral sling surgery for simple, “garden-variety” stress urinary incontinence (SUI). In their trial, 630 women were randomly assigned to undergo office evaluation with urodynamic tests (n = 315) or office evaluation only (n = 315). Surgical treatment was successful in 76.9% of women in the urodynamic-testing group and in 77.2% of women in the office evaluation-only group (95% confidence interval [CI], –7.5 to 6.9) as long as 1 year after surgery. There were no significant differences between groups in quality of life, patient satisfaction, and other secondary measures of incontinence severity. Investigators concluded that preoperative office evaluation (positive stress test, urethral hypermobility, normal postvoid residual, and negative urinalysis) is not inferior to urodynamic testing. CLICK HERE to read more |
