PURPOSE: To determine the utility of urodynamics (UDS) in patients with obstruction secondary to anti-incontinence surgery (AIS).
MATERIAL AND METHODS: We retrospectively reviewed all procedures to relieve obstruction due to AIS from 01/01-06/11. Patients were excluded if they had prior procedures to relieve obstruction, if follow-up data was missing, or if a neurologic disorder was present. Patients were grouped into the following categories prior to intervention: UDS diagnostic of obstruction vs. non-diagnostic UDS vs. no UDS testing. In addition we separated patients with predominantly storage symptoms vs. patients with incomplete emptying.
RESULTS: A total of 71 women were included in the analysis; 54 women presented with an elevated PVR, 33 (61%) were diagnosed with obstruction on UDS, 4 (7.4%) had non- diagnostic UDS and 17 (32%) did not undergo preoperative UDS. All 18 patients with predominantly storage symptoms underwent UDS. In patients with incomplete emptying there was no difference between groups with respect to improvement in storage or voiding symptoms, overall cure or success according to whether they had diagnostic UDS or not. In patients who had storage symptoms and underwent UDS, those without evidence of detrusor overactivity (DO) had significantly greater improvement of their storage symptoms when compared to those with DO (85.7% vs. 53.8%, p=0.02).
CONCLUSIONS: If voiding symptoms or urinary retention are the primary indication for intervention following AIS, UDS findings are not predictive of outcomes after intervention to relieve obstruction. If storage symptoms are the main indication for intervention, UDS may be valuable for patient counseling.
Written by:
Aponte MM, Shah SR, Hickling D, Brucker BM, Rosenblum N, Nitti VW. Are you the author?
Department of Urology, New York University Langone Medical Center, New York, NY, USA.
Reference: J Urol. 2013 Apr 5. pii: S0022-5347(13)04022-6.
doi: 10.1016/j.juro.2013.03.113
PubMed Abstract
PMID: 23567748
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