Heinz Koelbl led the peer-review process as the Associate Editor responsible for the paper.
Clinical Papers - Urodynamics
Article first published online: 6 APR 2012
Copyright © 2012 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 31, Issue 7, pages 1118–1123, September 2012
How to Cite
van Leijsen, S.A.L., Kluivers, K.B., Mol, B.W.J., Broekhuis, S.R., Milani, A.L., Bongers, M.Y., Aalders, C.I.M., Dietz, V., Malmberg, G.G. A., Vierhout, M.E. and Heesakkers, J.P.F.A. (2012), Can preoperative urodynamic investigation be omitted in women with stress urinary incontinence? A non-inferiority randomized controlled trial. Neurourol. Urodyn., 31: 1118–1123. doi: 10.1002/nau.22230
Conflict of interest: This study was entirely instigated by the responsible researchers. No commercial partner was involved in the study setup, study design or data collection. The authors have no conflicts of interest to declare.
Trial registration: Clinical Trials NCT00509730.
- Issue published online: 14 AUG 2012
- Article first published online: 6 APR 2012
- Manuscript Accepted: 26 JAN 2012
- Manuscript Received: 7 NOV 2011
- ZonMw, The Dutch Organization for Health, Research and Development. Grant Number: 945-07-203
- stress incontinence;
To assess in women with stress urinary incontinence (SUI) the value of urodynamics prior to treatment.
We performed a multicenter non-inferiority randomized controlled trial. Women with SUI were randomly allocated to management based on a workup with or without urodynamics. The primary outcome was clinical reduction of complaints as measured with the Urogenital Distress Inventory urinary incontinence subscale (UDI-UI) at 12 months after the onset of treatment. A mean difference in improvement of less than 8 was considered non-inferior. The study was analyzed according to intention-to-treat.
The trial was stopped prematurely because of slow recruitment. We randomly allocated 59 women to a strategy with (N = 31) or without (N = 28) urodynamics. The mean difference in improvement on the UDI-UI was 14 in favor of the group without urodynamics (48 SD ± 22 vs. 34 SD ± 22, 95% CI: −28 to −0.26), confirming non-inferiority. Addition of urodynamics did not result in a lower occurrence of de novo overactive bladder complaints compared to a workup without urodynamics (6/31 vs. 1/28; RR 5.4, 95% CI: 0.70–42). In the group allocated to urodynamics, initial surgical management was more often abandoned compared to the group not allocated to urodynamics (5/31 vs. 1/28; RR 4.5, 95% CI: 0.56–36).
In this relatively small study, the omission of urodynamics was not inferior to the use of urodynamics in the preoperative workup of women with SUI. Women with SUI undergoing urodynamics had the risk of a choice for more prudent treatment, which seemed to result in a delay until effective treatment. Neurourol. Urodynam. 31:1118–1123, 2012. © 2012 Wiley Periodicals, Inc.