International Urogynecology Journal

, Volume 23, Issue 7, pp 813–822 | Cite as

Do urodynamic parameters predict persistent postoperative stress incontinence after midurethral sling? A systematic review

  • Amie Kawasaki
  • Jennifer M. Wu
  • Cindy L. Amundsen
  • Alison C. Weidner
  • John P. Judd
  • Ethan M. Balk
  • Nazema Y. Siddiqui
Review Article


Introduction and hypothesis

It is unclear whether preoperative urodynamic study (UDS) values are predictive of outcomes after midurethral sling.

Materials and methods

We systematically reviewed multiple databases from January 1989 to October 2011 for English-language studies correlating UDS data with postoperative outcomes after midurethral slings. We performed random effects model meta-analyses, as indicated. Relative risk (RR) ratios for the outcome of stress urinary incontinence (SUI) cure were calculated using high maximum urethral closure pressure (MUCP) and Valsalva leak point pressure (VLPP) values as the reference group.


High preoperative MUCP was associated with cure after retropubic [RR 0.67; 95% confidence interval (CI) 0.47–0.97)] and transobturator slings (RR 0.65; 95% CI 0.49–0.90). High preoperative VLPP was also associated with cure after retropubic sling (RR 0.89; 95% CI 0.82–0.96), but this relationship did not achieve statistical significance for cure after transobturator sling (RR 0.86; 95% CI 0.74–1.00).


Preoperative MUCP and VLPP values may add insight into postoperative outcomes after surgical treatment for SUI.


Suburethral sling Urinary incontinence Urodynamics VLPP MUCP 


Conflicts of interest



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Copyright information

© The International Urogynecological Association 2012

Authors and Affiliations

  • Amie Kawasaki
    • 1
  • Jennifer M. Wu
    • 1
  • Cindy L. Amundsen
    • 1
  • Alison C. Weidner
    • 1
  • John P. Judd
    • 1
  • Ethan M. Balk
    • 2
  • Nazema Y. Siddiqui
    • 1
  1. 1.Department of Obstetrics & Gynecology, Division of UrogynecologyDuke University Medical CenterDurhamUSA
  2. 2.Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy StudiesTufts Medical CenterBostonUSA

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