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Clinical risk factors and urodynamic predictors prior to surgical treatment for stress urinary incontinence: a narrative review

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Abstract

Introduction and hypothesis

Knowledge about clinical risk factors and the value of urodynamic testing is important to optimize treatment strategy and secure true informed consent.

Methods

We reviewed the relevant literature to clarify the evidence regarding clinical risk factors and the predictive value of urodynamic testing in patients with urinary incontinence, where surgery is considered. Because of the paucity of evidence based on randomized controlled trials, we conducted a narrative review of the published literature.

Results

Clinical risk factors in terms of mixed urinary incontinence, previous incontinence surgery, body mass index (BMI) ≥ 35, age ≥ 75, and presence of diabetes mellitus were significantly related to decreased outcome of incontinence surgery. Furthermore, noninvasive and invasive urodynamic parameters indicating detrusor overactivity, voiding difficulties, low urethral pressure, and bladder-neck immobility were related to poorer outcome of surgery.

Conclusions

This study summarized the available evidence regarding preoperative clinical risk factors and urodynamic parameters indicating decreased or adverse outcome of surgery, and this report also provides clinical recommendations.

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Abbreviations

ICI:

International Consultation on Incontinence

ICS:

International Continence Society

IUGA:

International Urogynecological Association

DO:

Detrusor overactivity

DOI:

Detrusor overactivity incontinence

FDS:

First desire to void

LUT:

Lower urinary tract

LUTS:

Lower urinary tract symptoms

MUI:

Mixed urinary incontinence

MUS:

Midurethral sling

NDS:

Normal desire to void

NPV:

Negative predictive value

OAB:

Overactive bladder syndrome

Pabd:

Abdominal pressure

Pdet:

Detrusor pressure

Pves:

Bladder pressure

PPV:

Positive predictive value

PVR:

Postvoid residual (urine volume)

SUI:

Stress urinary incontinence

UI:

Urinary incontinence

UP:

Urethral pressure

USI:

Urodynamic stress incontinence

UUI:

Urgency urinary incontinence

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Conflicts of interest

M.H. Bing, H. Gimbel, S. Greisen, L.B. Paulsen, and H.C. Soerensen have no conflicts of interest to declare. G. Lose has research cooperation with Coloplast under a grant from Advanced Technology Foundation.

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Authors and Affiliations

  1. Department Gynecology/Obstetrics, Herlev University Hospital, Herlev, Denmark

    Mette Hornum Bing, Lene Birgitte Paulsen, Helle Christina Soerensen & Gunnar Lose

  2. Department Gynecology/Obstetrics, Nykoebing Falster Hospital, Nykoebing Falster, Denmark

    Helga Gimbel

  3. Department Gynecology/Obstetrics, Aarhus University Hospital, Skejby, Denmark

    Susanne Greisen

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  1. Mette Hornum Bing
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  2. Helga Gimbel
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  6. Gunnar Lose
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Correspondence to Mette Hornum Bing.

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Bing, M.H., Gimbel, H., Greisen, S. et al. Clinical risk factors and urodynamic predictors prior to surgical treatment for stress urinary incontinence: a narrative review. Int Urogynecol J 26, 175–185 (2015). https://doi.org/10.1007/s00192-014-2489-4

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