Urodynamic investigations for management of urinary incontinence in children and adults

  • Review
  • Intervention




Urodynamic tests are used to investigate people who have urinary incontinence or other urinary symptoms in order to make a definitive objective diagnosis. The aim is to help to select the treatment most likely to be successful. The investigations are invasive and time consuming.


The objective of this review was to discover if treatment according to a urodynamic-based diagnosis led to clinical improvements in urinary incontinence outcomes, compared to treatment based on history and examination.

Search methods

We searched the Cochrane Incontinence Group Specialised Trials Register (searched 29 May 2006) and reference lists of relevant articles.

Selection criteria

Randomised and quasi-randomised trials comparing clinical outcomes in groups of people who were and were not investigated using urodynamics, or comparing one type of urodynamics against another.

Data collection and analysis

Two reviewers independently assessed trial quality and extracted data.

Main results

Three small trials involving 184 people were included but data were only available for 128 participants. In one small trial, women who were investigated with urodynamics were more likely to receive active treatment with drugs or surgery. However, the numbers in the trials were too small to determine if this affected clinical outcomes such as a reduction in incontinence.

Authors' conclusions

A larger definitive trial is needed, in which people are randomly allocated to management according to urodynamic findings or to standard management based on history and clinical examination.

Plain language summary

Urodynamic investigations (tests) for the management of urinary incontinence in children and adults

Urinary incontinence is the inability to control urination (passing water). It can be caused by a number of problems. Urodynamic tests try to measure nerve and muscle function, pressures around and in the bladder, flow rates and other factors which might help to explain a person's incontinence. Some people find these tests embarrassing and uncomfortable. However, they might show what the cause of the incontinence is, or what sort of incontinence the person has, so that the most correct treatment can be chosen. This may improve the success of the treatment.

Three small trials were found, which included 184 people, although information was only available for 128 participants. There was not enough evidence to determine whether these tests lead to better outcomes. There was some evidence that urodynamic testing increased the number of people prescribed drug treatments or treated by surgery, but it was not known whether this resulted in less incontinence or a better quality of life.

More research is needed, in which people are randomised to having treatment decisions based on either their symptoms and examination alone, or the extra information provided by urodynamic tests.