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Examining the Evidence

Does urodynamic testing before surgery for stress incontinence improve outcomes?

December 2012 · Vol. 24, No. 12


CLICK HERE to access 8 other articles about treating urinary incontinence and urinary tract infections, published in OBG Management in 2012.

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.

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