The role of urodynamics in women with stress urinary incontinence

Abstract

Stress urinary incontinence (SUI) is a common condition with no standardized evaluation prior to surgery. The role of urodynamic studies (UDS) in the assessment of SUI has been the subject of considerable debate over the years. The Royal College of Obstetricians and Gynaecologists recommends urodynamic testing prior to surgery for SUI. This review gives an overview and discusses the evidence of UDS prior to surgery. It is apparent from the literature that UDS provides the clinicians with a wealth of information which may be used to refine treatment decisions in complex cases. However, its use in “pure stress incontinence” continues to be a source of controversy. There is a need for improved standardization of urodynamic studies such as abdominal leak point pressures and urethral pressure profiles before any further conclusions can be drawn about their utility in predicting the success of surgery in SUI. Prospective randomized controlled trials to evaluate the clinical efficacy, cost effectiveness, and effect on quality of life issues of a full preoperative UDS compared to no UDS studies trials is urgently needed
before any firm conclusion can be drawn regarding the superiority of UDS.