Urodynamic studies for management of urinary incontinence in children and adults: A short version Cochrane systematic review and meta‐analysis. Issue 5 (22nd May 2014)

• Record Type: Journal Article
• Authors: Clement, Keiran David; Lapitan, Marie Carmela M.; Omar, Muhammad Imran; Glazener, Cathryn Margaret Anne
• Is Part Of: Neurourology and urodynamics. Volume 34:Issue 5(2015:Jun.)
• Page Start: 407
• Page End: 412
• Publication Date: 2014-05-22
• Subjects: Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.22584
• Languages: English
• ISSNs: 0733-2467

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="nau22584-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="nau22584-sec-0002" sec-type="section"> <title>Objectives</title> <p>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.</p> </sec> <sec id="nau22584-sec-0003" sec-type="section"> <title>Search Methods</title> <p>Cochrane Incontinence Group Specialized Register (searched February 19, 2013); reference lists of relevant articles.</p> </sec> <sec id="nau22584-sec-0004" sec-type="section"> <title>Selection Criteria</title> <p>Randomized and quasi‐randomized trials in people who were and were not investigated using urodynamics, or comparing one type of urodynamic test against another.</p> </sec> <sec id="nau22584-sec-0005" sec-type="section"> <title>Data Collection and Analysis</title> <p>At least two independent review authors carried out trial assessment, selection, and data abstraction.</p> </sec> <sec id="nau22584-sec-0006" sec-type="section"> <title>Results</title> <p>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).</p> <p>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).</p> </sec> <sec id="nau22584-sec-0007" sec-type="section"> <title>Authors' Conclusions</title> <p>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. <italic>Neurourol. Urodynam. 34:407–412, 2015</italic>. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>