Women with pure stress urinary incontinence symptoms assessed by the initial standard evaluation including measurement of post-void residual volume and a stress test: Are urodynamic studies still needed?

Seong Jin Jeong, Hyeon June Kim, Byung Ki Lee, Woong Rha, Jong Jin Oh, Chang Wook Jeong, Jeong Hyun Kim, Cheol Yong Yoon, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Aims The significance of preoperative urodynamic studies in women with a "clinically-defined pure stress urinary incontinence (SUI) symptom" has been debated in recent years. We evaluated changes of reliability of pure SUI symptoms for prediction of pure urodynamic SUI (USUI) when the assessment of post-void residual (PVR) volume and a stress test, designated as the initial standard evaluation in the NICE and AUA guidelines, were added to the process for the diagnosis of pure SUI symptoms. Methods We reviewed records of 1,019 women aged 30-80 who underwent urodynamic study for incontinence. Criteria for pure SUI symptoms were defined as absence of overactive bladder symptoms and voiding difficulties based on a frequency-volume chart and AUA Symptom Index. We then added assessment of PVR volume and a stress test to the process for clinical diagnosis. Results Of subjects, 211 (20.7%) could be classified as having a pure SUI symptom. Of these, only 167 (79.1%) had pure USUI and 33 (15.7%) had detrusor overactivity. Eight (3.8%) had detrusor underactivity/bladder outlet obstruction. Sensitivity and specificity of pure SUI symptoms for pure USUI were 28.6% and 89.9%. Addition of assessment of PVR volume and a stress test resulted in an increase of predictive accuracy of only 3.6%. Conclusions As one-fifth of women with pure SUI symptoms exhibit the pathophysiologies that could affect the surgical outcomes despite additional use of PVR assessment and a stress test in the clinical diagnostic process, urodynamic evaluation is considered necessary before anti-incontinence surgery in this population.

Original languageEnglish
Pages (from-to)508-512
Number of pages5
JournalNeurourology and Urodynamics
Volume31
Issue number4
DOIs
StatePublished - 1 Apr 2012

Fingerprint

Residual Volume
Stress Urinary Incontinence
Urodynamics
Exercise Test
Urinary Bladder Neck Obstruction
Overactive Urinary Bladder
Guidelines
Sensitivity and Specificity

Keywords

  • diagnosis
  • guideline
  • stress
  • symptoms
  • urinary incontinence
  • urodynamics

Cite this

@article{0c56236b1985412c8a7e65767d8acd3b,
title = "Women with pure stress urinary incontinence symptoms assessed by the initial standard evaluation including measurement of post-void residual volume and a stress test: Are urodynamic studies still needed?",
abstract = "Aims The significance of preoperative urodynamic studies in women with a {"}clinically-defined pure stress urinary incontinence (SUI) symptom{"} has been debated in recent years. We evaluated changes of reliability of pure SUI symptoms for prediction of pure urodynamic SUI (USUI) when the assessment of post-void residual (PVR) volume and a stress test, designated as the initial standard evaluation in the NICE and AUA guidelines, were added to the process for the diagnosis of pure SUI symptoms. Methods We reviewed records of 1,019 women aged 30-80 who underwent urodynamic study for incontinence. Criteria for pure SUI symptoms were defined as absence of overactive bladder symptoms and voiding difficulties based on a frequency-volume chart and AUA Symptom Index. We then added assessment of PVR volume and a stress test to the process for clinical diagnosis. Results Of subjects, 211 (20.7{\%}) could be classified as having a pure SUI symptom. Of these, only 167 (79.1{\%}) had pure USUI and 33 (15.7{\%}) had detrusor overactivity. Eight (3.8{\%}) had detrusor underactivity/bladder outlet obstruction. Sensitivity and specificity of pure SUI symptoms for pure USUI were 28.6{\%} and 89.9{\%}. Addition of assessment of PVR volume and a stress test resulted in an increase of predictive accuracy of only 3.6{\%}. Conclusions As one-fifth of women with pure SUI symptoms exhibit the pathophysiologies that could affect the surgical outcomes despite additional use of PVR assessment and a stress test in the clinical diagnostic process, urodynamic evaluation is considered necessary before anti-incontinence surgery in this population.",
keywords = "diagnosis, guideline, stress, symptoms, urinary incontinence, urodynamics",
author = "Jeong, {Seong Jin} and Kim, {Hyeon June} and Lee, {Byung Ki} and Woong Rha and Oh, {Jong Jin} and Jeong, {Chang Wook} and Kim, {Jeong Hyun} and Yoon, {Cheol Yong} and Hong, {Sung Kyu} and Seok-Soo Byun and Lee, {Sang Eun}",
year = "2012",
month = "4",
day = "1",
doi = "10.1002/nau.21215",
language = "English",
volume = "31",
pages = "508--512",
journal = "Neurourology and Urodynamics",
issn = "0733-2467",
publisher = "Wiley-Liss Inc.",
number = "4",

}

TY - JOUR

T1 - Women with pure stress urinary incontinence symptoms assessed by the initial standard evaluation including measurement of post-void residual volume and a stress test

T2 - Are urodynamic studies still needed?

AU - Jeong, Seong Jin

AU - Kim, Hyeon June

AU - Lee, Byung Ki

AU - Rha, Woong

AU - Oh, Jong Jin

AU - Jeong, Chang Wook

AU - Kim, Jeong Hyun

AU - Yoon, Cheol Yong

AU - Hong, Sung Kyu

AU - Byun, Seok-Soo

AU - Lee, Sang Eun

PY - 2012/4/1

Y1 - 2012/4/1

N2 - Aims The significance of preoperative urodynamic studies in women with a "clinically-defined pure stress urinary incontinence (SUI) symptom" has been debated in recent years. We evaluated changes of reliability of pure SUI symptoms for prediction of pure urodynamic SUI (USUI) when the assessment of post-void residual (PVR) volume and a stress test, designated as the initial standard evaluation in the NICE and AUA guidelines, were added to the process for the diagnosis of pure SUI symptoms. Methods We reviewed records of 1,019 women aged 30-80 who underwent urodynamic study for incontinence. Criteria for pure SUI symptoms were defined as absence of overactive bladder symptoms and voiding difficulties based on a frequency-volume chart and AUA Symptom Index. We then added assessment of PVR volume and a stress test to the process for clinical diagnosis. Results Of subjects, 211 (20.7%) could be classified as having a pure SUI symptom. Of these, only 167 (79.1%) had pure USUI and 33 (15.7%) had detrusor overactivity. Eight (3.8%) had detrusor underactivity/bladder outlet obstruction. Sensitivity and specificity of pure SUI symptoms for pure USUI were 28.6% and 89.9%. Addition of assessment of PVR volume and a stress test resulted in an increase of predictive accuracy of only 3.6%. Conclusions As one-fifth of women with pure SUI symptoms exhibit the pathophysiologies that could affect the surgical outcomes despite additional use of PVR assessment and a stress test in the clinical diagnostic process, urodynamic evaluation is considered necessary before anti-incontinence surgery in this population.

AB - Aims The significance of preoperative urodynamic studies in women with a "clinically-defined pure stress urinary incontinence (SUI) symptom" has been debated in recent years. We evaluated changes of reliability of pure SUI symptoms for prediction of pure urodynamic SUI (USUI) when the assessment of post-void residual (PVR) volume and a stress test, designated as the initial standard evaluation in the NICE and AUA guidelines, were added to the process for the diagnosis of pure SUI symptoms. Methods We reviewed records of 1,019 women aged 30-80 who underwent urodynamic study for incontinence. Criteria for pure SUI symptoms were defined as absence of overactive bladder symptoms and voiding difficulties based on a frequency-volume chart and AUA Symptom Index. We then added assessment of PVR volume and a stress test to the process for clinical diagnosis. Results Of subjects, 211 (20.7%) could be classified as having a pure SUI symptom. Of these, only 167 (79.1%) had pure USUI and 33 (15.7%) had detrusor overactivity. Eight (3.8%) had detrusor underactivity/bladder outlet obstruction. Sensitivity and specificity of pure SUI symptoms for pure USUI were 28.6% and 89.9%. Addition of assessment of PVR volume and a stress test resulted in an increase of predictive accuracy of only 3.6%. Conclusions As one-fifth of women with pure SUI symptoms exhibit the pathophysiologies that could affect the surgical outcomes despite additional use of PVR assessment and a stress test in the clinical diagnostic process, urodynamic evaluation is considered necessary before anti-incontinence surgery in this population.

KW - diagnosis

KW - guideline

KW - stress

KW - symptoms

KW - urinary incontinence

KW - urodynamics

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U2 - 10.1002/nau.21215

DO - 10.1002/nau.21215

M3 - Review article

C2 - 22374678

AN - SCOPUS:84862794725

VL - 31

SP - 508

EP - 512

JO - Neurourology and Urodynamics

JF - Neurourology and Urodynamics

SN - 0733-2467

IS - 4

ER -