Urodynamic Changes 24 Months After Burch Colposuspension and Autologous Fascia Pubovaginal Sling

 

Introduction

The purpose of this analysis was to determine the reference urodynamic values for preoperative urodynamic studies in women undergoing surgery for pure or predominant stress urinary incontinence (SUI) by describing values in a large cohort of women.

Methods

Six hundred fifty five (655)women with pure or predominant SUI were enrolled in a multicenter surgical trial and were randomized to undergo a Burch or autologous fascia sling procedure as part of the Urinary Incontinence Treatment Network (UITN) Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr). Preoperative free uroflowmetry, filling cystometry(CMG), and pressure flow studies(PFS) were performed in all women using a standardized research protocol and standardized urodynamic interpretation guidelines. The details of our urodynamic protocol have been published (Urology, 69: 63, 2007), and the specific UDS Protocol and UDS Interpretation Guidelines are available on the UITN website at http://www.uitn.net/resourcesforphysicians.htm. Validity and plausibility screening was performed, as described in our guidelines, and only urodyanamic studies that passed these quality control screening assessments were included in the results below. We define the normal range of urodynamic values in this population as the values that encompass 95% of the results.

Results

Table 1: Free uroflowmetry values (n=588). Of the 655 subjects in the SISTEr study, 588 had adequate volume voids and recorded values for all uroflowmetry values.

Table 2: CMG values. Sixty (60) subjects (10%) did not demonstrate urodynamic stressincontinence (USI); 86 leaked only with cough at MCC; and 21 leaked only after prolapse reduction (not included in VLPP data). Four hundred twenty eight (428) subjects leaked at least twice during Valsalva maneuvers and met VLPP plausibility criteria.

Table 3: PFS values.

Conclusions

Many women undergoing surgery for pure or predominant stress incontinence have preoperative free uroflowmetry, filling cystometry studies, and pressure flow studies. Results from a large cohort of these women are now available for plausibility and quality control assessments or as reference values for similar groups of women.

Keywords

Urodynamics, Stress Urinary Incontinence, multicenter study, reference values, plausibility

Full manuscript for this abstract: Nager, C. W., Albo, M. E., Fitzgerald, M. P., McDermott, S., Wruck, L., Kraus, S. et al.: Reference urodynamic values for stress incontinent women. Neurourol Urodyn, 26: 333, 2007

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