Office Evaluation Comparable to Pre-Op Urodynamic Testing

For women with stress incontinence, treatment success noninferior with pre-op office evaluation

THURSDAY, May 3 (HealthDay News) -- For women with uncomplicated stress incontinence, preoperative office evaluation alone is noninferior to urodynamic testing with respect to success of treatment at one year, according to a study published online May 2 in the New England Journal of Medicine.

Charles W. Nager, M.D., from the University of California at San Diego, and colleagues conducted a multicenter, randomized, noninferiority trial to investigate whether urodynamic studies improve outcomes for women with uncomplicated stress urinary incontinence who undergo surgery. Six hundred thirty women were randomized in a 1:1 ratio to undergo office evaluation with urodynamic tests or just evaluation.

The investigators found that evaluation alone was noninferior to urodynamic testing at one year, with successful treatment seen for 77.2 percent of women in the evaluation-only group, compared with 76.9 percent in the urodynamic-testing group. There were no significant differences seen between the groups in any secondary measures (severity of incontinence, quality of life, patient satisfaction, positive provocative stress test rates, voiding dysfunction, or adverse events).

"These results argue against routine preoperative urodynamic testing in patients with uncomplicated stress urinary incontinence," the authors write.

Several authors disclosed financial relationships with pharmaceutical and biotechnology companies.

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