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- Title
Urodynamic evaluation: can it prevent the need for surgical intervention in women with apparent pure stress urinary incontinence?
- Authors
Serati, Maurizio; Cattoni, Elena; Siesto, Gabriele; Braga, Andrea; Sorice, Paola; Cantaluppi, Simona; Cromi, Antonella; Ghezzi, Fabio; Vitobello, Domenico; Bolis, Pierfrancesco; Salvatore, Stefano
- Abstract
Objectives To identify how many patients with symptoms of pure stress urinary incontinence ( SUI) do not require any surgical treatment on the basis of urodynamics ( UDS) and how many patients still do not require surgery 1 year after UDS., To assess the outcomes of these patients at 12-month follow-up., Patients and methods Women with pure SUI received UDS and were prospectively divided into four groups, comprising women with: urodynamic stress incontinence ( USI); detrusor overactivity ( DO); USI + DO; and inconclusive UDS., Women with USI underwent a Tension Free Vaginal Tape ( Obturator) ( TVT- O) procedure ( Gynecare; Ethicon Inc., Somerville, NJ, USA), whereas women with DO ±/− USI were recommended 24-week antimuscarinic therapy., Follow-up was scheduled at 3 and 12 months. To define subjective outcomes, all patients completed the International Consultation on Incontinence Questionnaire - short form, the Patient Global Impression - Improvement and the Urinary Distress Inventory., Patients were considered cured if they presented a negative stress test, a score reduction of at least 80% on the Urinary Distress Inventory and a response of 'much better' or 'very much better' on the Patient Global Impression - Improvement., Results Of the 263 women with pure SUI, 74.5% had a urodynamic diagnosis of USI, 10.6% had DO, 8% had USI + DO and 6.8% had inconclusive UDS., At 12-month follow-up, 165/181 (91.6%) women in group 1 were considered cured post- TVT- O; in the other groups, 33/67 (49.2%) patients were considered cured simply as a result of taking antimuscarinics; 13 of these 67 patients required TVT- O., Conclusions UDS is able to show that several patients with symptoms of pure SUI present an underlying DO and do not require surgery, even 1 year after UDS., In these patients, antimuscarinic treatment appears to ensure a good rate of cure; thus, UDS could lead to the avoidance of several surgical procedures.
- Subjects
WOMEN patients; URODYNAMICS; PATIENTS; MUSCARINIC antagonists; SYMPTOMS; HEALTH; DIAGNOSIS; THERAPEUTICS; DISEASES
- Publication
BJU International, 2013, Vol 112, Issue 4, pE344
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/bju.12007