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 journalArticlepeer-review

24 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

Bibliographical 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.

Keywords

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

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