Get access

Urodynamic studies for management of urinary incontinence in children and adults: A short version Cochrane systematic review and meta-analysis

Authors

  • Keiran David Clement,

    1. Cochrane Incontinence Review Group, University of Aberdeen, Aberdeen, United Kingdom
    Search for more papers by this author
  • Marie Carmela M. Lapitan,

    1. Cochrane Incontinence Review Group, University of Aberdeen, Aberdeen, United Kingdom
    2. National Institutes of Health Manila, University of the Philippines Manila, Manila, Philippines
    Search for more papers by this author
  • Muhammad Imran Omar,

    1. Cochrane Incontinence Review Group, University of Aberdeen, Aberdeen, United Kingdom
    Search for more papers by this author
  • Cathryn Margaret Anne Glazener

    Corresponding author
    1. Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
    • Correspondence to: Prof. Cathryn Margaret Anne Glazener, Health Services Research Unit, University of Aberdeen, 3rd Floor, Health Sciences Building Foresterhill, Aberdeen AB25 2ZD, United Kingdom. E-mail: c.glazener@abdn.ac.uk

    Search for more papers by this author

  • Citation for full version of review: Clement KD, Lapitan MCM, Omar MI, Glazener CMA. Urodynamic studies for management of urinary incontinence in children and adults. Cochrane Database of Systematic Reviews 2013, Issue 10. Art. No.: CD003195. D O I: 10.1002/14651858.CD003195.pub3.
  • This paper is based on a Cochrane review (Clement 2013) published in The Cochrane Library (see www.thechochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and The Cochrane Library should be consulted for the most recent version of the review. If you wish to comment on this or other Cochrane Reviews, please use the Cochrane Library Feedback System. The results of a Cochrane Review can be interpreted differently, depending on people's perspectives and circumstances. Please consider the conclusions presented carefully. They are the opinions of the review authors, and are not necessarily shared by The Cochrane Collaboration.
  • Contributions of authors: All review authors independently assessed the studies for inclusion, extracted data and wrote the text.
  • Christopher Chapple led the peer-review process as the Associate Editor responsible for the paper.
  • Conflict of interest: none.

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. Neurourol. Urodynam. 34:407–412, 2015. © 2014 Wiley Periodicals, Inc.

Ancillary