Urodynamic studies for management of urinary incontinence in children and adults

A short version Cochrane systematic review and meta-analysis

Keiran David Clement, Marie Carmela M. Lapitan, Muhammad Imran Omar, Cathryn Margaret Anne Glazener

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

BACKGROUND: Urodynamic tests are used to investigate people who have urinary incontinence or other urinary symptoms in order to make an objective diagnosis. The investigations are invasive and time consuming.

OBJECTIVES: To determine if treatment according to a urodynamic-based diagnosis, compared to treatment based on history and examination, leads to more effective clinical care and better clinical outcomes.

SEARCH METHODS: Cochrane Incontinence Group Specialized Register (searched February 19, 2013); reference lists of relevant articles.

SELECTION CRITERIA: Randomized and quasi-randomized trials in people who were and were not investigated using urodynamics, or comparing one type of urodynamic test against another.

DATA COLLECTION AND ANALYSIS: At least two independent review authors carried out trial assessment, selection, and data abstraction.

RESULTS: We found eight trials but data were available for only 1,036 women in seven trials. Women undergoing urodynamics were more likely to have their management changed (17% vs. 3%, risk ratio [RR] 5.07, 95% CI 1.87-13.74). Two trials suggested that women were more likely to receive drugs (RR 2.09, 95% CI 1.32-3.31), but, in five trials, women were not more likely to undergo surgery (RR 0.99, 95% CI 0.88-1.12). There was no statistically significant difference in urinary incontinence in women who had urodynamics (37%) compared with those undergoing history and clinical examination alone (36%) (RR 1.02, 95% CI 0.86-1.21).

AUTHORS' CONCLUSIONS: While urodynamics did change clinical decision-making, there was some high-quality evidence that this did not result in lower urinary incontinence rates after treatment.
Original languageEnglish
Pages (from-to)407-412
Number of pages6
JournalNeurourology and Urodynamics
Volume34
Issue number5
Early online date22 May 2014
DOIs
Publication statusPublished - Jun 2015

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Urodynamics
Urinary Incontinence
Meta-Analysis
Odds Ratio
History
Therapeutics
Pharmaceutical Preparations

Keywords

  • Cochrane systematic review
  • randomized controlled trials
  • urodynamics
  • urinary continence
  • women

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology

Cite this

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title = "Urodynamic studies for management of urinary incontinence in children and adults: A short version Cochrane systematic review and meta-analysis",
abstract = "BACKGROUND: Urodynamic tests are used to investigate people who have urinary incontinence or other urinary symptoms in order to make an objective diagnosis. The investigations are invasive and time consuming.OBJECTIVES: To determine if treatment according to a urodynamic-based diagnosis, compared to treatment based on history and examination, leads to more effective clinical care and better clinical outcomes.SEARCH METHODS: Cochrane Incontinence Group Specialized Register (searched February 19, 2013); reference lists of relevant articles.SELECTION CRITERIA: Randomized and quasi-randomized trials in people who were and were not investigated using urodynamics, or comparing one type of urodynamic test against another.DATA COLLECTION AND ANALYSIS: At least two independent review authors carried out trial assessment, selection, and data abstraction.RESULTS: We found eight trials but data were available for only 1,036 women in seven trials. Women undergoing urodynamics were more likely to have their management changed (17{\%} vs. 3{\%}, risk ratio [RR] 5.07, 95{\%} CI 1.87-13.74). Two trials suggested that women were more likely to receive drugs (RR 2.09, 95{\%} CI 1.32-3.31), but, in five trials, women were not more likely to undergo surgery (RR 0.99, 95{\%} CI 0.88-1.12). There was no statistically significant difference in urinary incontinence in women who had urodynamics (37{\%}) compared with those undergoing history and clinical examination alone (36{\%}) (RR 1.02, 95{\%} CI 0.86-1.21).AUTHORS' CONCLUSIONS: While urodynamics did change clinical decision-making, there was some high-quality evidence that this did not result in lower urinary incontinence rates after treatment.",
keywords = "Cochrane systematic review, randomized controlled trials, urodynamics, urinary continence, women",
author = "Clement, {Keiran David} and Lapitan, {Marie Carmela M.} and Omar, {Muhammad Imran} and Glazener, {Cathryn Margaret Anne}",
note = "Funded by National Institute for Health Research (NIHR) ACKNOWLEDGMENTS The National Institute for Health Research (NIHR) is the largest single funder of the Cochrane Incontinence Group. Phil Toozs-Hobson provided extra information about one trial, and Sanne van Leijsen about one completed trial. We also thank Andrew Elders who calculated the number needed for further research.",
year = "2015",
month = "6",
doi = "10.1002/nau.22584",
language = "English",
volume = "34",
pages = "407--412",
journal = "Neurourology and Urodynamics",
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T1 - Urodynamic studies for management of urinary incontinence in children and adults

T2 - A short version Cochrane systematic review and meta-analysis

AU - Clement, Keiran David

AU - Lapitan, Marie Carmela M.

AU - Omar, Muhammad Imran

AU - Glazener, Cathryn Margaret Anne

N1 - Funded by National Institute for Health Research (NIHR) ACKNOWLEDGMENTS The National Institute for Health Research (NIHR) is the largest single funder of the Cochrane Incontinence Group. Phil Toozs-Hobson provided extra information about one trial, and Sanne van Leijsen about one completed trial. We also thank Andrew Elders who calculated the number needed for further research.

PY - 2015/6

Y1 - 2015/6

N2 - BACKGROUND: Urodynamic tests are used to investigate people who have urinary incontinence or other urinary symptoms in order to make an objective diagnosis. The investigations are invasive and time consuming.OBJECTIVES: To determine if treatment according to a urodynamic-based diagnosis, compared to treatment based on history and examination, leads to more effective clinical care and better clinical outcomes.SEARCH METHODS: Cochrane Incontinence Group Specialized Register (searched February 19, 2013); reference lists of relevant articles.SELECTION CRITERIA: Randomized and quasi-randomized trials in people who were and were not investigated using urodynamics, or comparing one type of urodynamic test against another.DATA COLLECTION AND ANALYSIS: At least two independent review authors carried out trial assessment, selection, and data abstraction.RESULTS: We found eight trials but data were available for only 1,036 women in seven trials. Women undergoing urodynamics were more likely to have their management changed (17% vs. 3%, risk ratio [RR] 5.07, 95% CI 1.87-13.74). Two trials suggested that women were more likely to receive drugs (RR 2.09, 95% CI 1.32-3.31), but, in five trials, women were not more likely to undergo surgery (RR 0.99, 95% CI 0.88-1.12). There was no statistically significant difference in urinary incontinence in women who had urodynamics (37%) compared with those undergoing history and clinical examination alone (36%) (RR 1.02, 95% CI 0.86-1.21).AUTHORS' CONCLUSIONS: While urodynamics did change clinical decision-making, there was some high-quality evidence that this did not result in lower urinary incontinence rates after treatment.

AB - BACKGROUND: Urodynamic tests are used to investigate people who have urinary incontinence or other urinary symptoms in order to make an objective diagnosis. The investigations are invasive and time consuming.OBJECTIVES: To determine if treatment according to a urodynamic-based diagnosis, compared to treatment based on history and examination, leads to more effective clinical care and better clinical outcomes.SEARCH METHODS: Cochrane Incontinence Group Specialized Register (searched February 19, 2013); reference lists of relevant articles.SELECTION CRITERIA: Randomized and quasi-randomized trials in people who were and were not investigated using urodynamics, or comparing one type of urodynamic test against another.DATA COLLECTION AND ANALYSIS: At least two independent review authors carried out trial assessment, selection, and data abstraction.RESULTS: We found eight trials but data were available for only 1,036 women in seven trials. Women undergoing urodynamics were more likely to have their management changed (17% vs. 3%, risk ratio [RR] 5.07, 95% CI 1.87-13.74). Two trials suggested that women were more likely to receive drugs (RR 2.09, 95% CI 1.32-3.31), but, in five trials, women were not more likely to undergo surgery (RR 0.99, 95% CI 0.88-1.12). There was no statistically significant difference in urinary incontinence in women who had urodynamics (37%) compared with those undergoing history and clinical examination alone (36%) (RR 1.02, 95% CI 0.86-1.21).AUTHORS' CONCLUSIONS: While urodynamics did change clinical decision-making, there was some high-quality evidence that this did not result in lower urinary incontinence rates after treatment.

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KW - urodynamics

KW - urinary continence

KW - women

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