Position of the Ibero-American Society of Neurourology and Urogynecology (SINUG) on the urodynamics (UDS) in women undergoing surgical treatment for stress urinary incontinence (SUI)
Medina-Polo, José (Hospital Universitario 12 de Octubre (Madrid))
Arlandis, Salvador (Hospital Universitari i Politècnic La Fe (València))
Martinez-Garcia, Roberto (Hospital Clínic Universitari (València))
Padilla-Fernández, Bárbara (Hospital Universitario de Canarias (La Laguna))
Castro Díaz, David (Hospital Universitario de Canarias (La Laguna))
Cruz, F. (University of Porto (Portugal))
Errando-Smet, Carlos (Institut de Recerca Sant Pau)
Espuña-Pons, Montserrat (Hospital Clínic i Provincial de Barcelona)
González Enguita, María del Carmen (Hospital Universitario Fundación Jiménez Díaz)
López-Fando, Luís (Hospital Universitario de la Princesa (Madrid))
Martin Martínez, Alicia (Complejo Hospitalario Universitario Insular Materno Infantil (Las Palmas de Gran Canaria))
Martínez-Cuenca, Esther (Hospital Universitari i Politècnic La Fe (València))
Montes-Posada, Isabel (Hospital Universitario de Gran Canaria Dr. Negrín)
Müller-Arteaga, Carlos (Hospital Álvaro Cunqueiro (Vigo))
Muñoz Menéndez, Ana Belén (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Ramírez-García, Inés (Universitat Ramon Llull. Facultat de Ciències de la Salut Blanquerna)
Ros, Cristina (Hospital Clínic i Provincial de Barcelona)
Blasco, Pedro (Hospital Universitario Virgen de Valme (Sevilla, Andalusia))
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Introduction: Most clinical practice guidelines currently recommend not to necessary perform routine urodynamic studies (UDS) before surgery for female stress urinary incontinence (SUI). However, there is no consensus in the literature. Our objective was to evaluate the available evidence and to establish a position as a scientific society. Methods: A search was conducted using PubMed, Web of Science and Scopus databases. Inclusion criteria were manuscripts in English with the terms "female urinary incontinence" and "urodynamics". The analysis included 25 studies. Results: Regarding the usefulness of UDS in female undergoing SUI, two randomised, controlled trials have been published showing that preoperative UDS do not improve the results of SUI surgery. The review of data from different series on the surgical treatment of female SUI shows that up to 36% of patients undergoing surgery for SUI are complicated cases due to previous anti-incontinence surgery, pelvic prolapse that exceeds the hymen, radiotherapy or pelvic surgery. Moreover, the performance of UDS before treatment of SUI leads to a change in diagnostic orientation in 74% of patients with complicated SUI and 40% in the case of uncomplicated SUI. It should be noted that the UDS study modifies the proposed treatment in 23. 8% and 11% of patients with complicated and uncomplicated SUI, respectively. A review by Serati et al. reported that the UDS results are congruent with the clinical diagnosis of SUI in 74. 5% of cases. However, there is overactive detrusor in 10. 6%, mixed urinary incontinence in 8% and the results of the UDS are inconclusive in 6. 8% of cases. Therefore, it is estimated that UDS before surgery is more likely to change the management of SUI in 17% of patients. Conclusions: In women referring SUI, it is necessary to individualise the indication for UDS before surgical correction. UDS are complementary tests to be considered after non-invasive studies of the patient with a detailed clinical history, physical examination and other complementary tests such as a voiding diary, specific questionnaires and flowmetry with residual urine. We consider it necessary in cases of complicated or non-pure SUI.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Outcomes ; Stress urinary incontinence (SUI) ; Surgery ; Systematic review ; Urodynamics (UDS)
Publicat a:	Continence, Vol. 12 (december 2024) , p. 101714, ISSN 2772-9737

DOI: 10.1016/j.cont.2024.101714

7 p, 755.1 KB

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