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A randomized controlled trial of urodynamic investigations prior to conservative treatment of urinary incontinence in the female

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Abstract

Sixty patients complaining of frequency, urgency, nocturia, urge incontinence and stress incontinence were randomly allocated to either undergo conservative treatment by way of combined physiotherapy and bladder retraining as an inpatient without prior urodynamics, or to have urodynamic investigations and treatment tailored to the urodynamic diagnosis. The assessment period was 3 months and assessment was made pre- and posttreatment by urinary diary, pad testing and subjective questionnaire. There was a significant improvement posttreatment for each parameter studied, with the exception of pad testing. There was no significant difference between the two groups for any parameter. Two-thirds of patients were cured to the extent that they did not require further treatment, and again there was no difference between the two groups. We conclude that patients attending for the first time with an uncomplicated story of urinary incontinence can be effectively treated conservatively without prior urodynamics.

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References

  1. Bates CP, Loose H, Stanton SL. Objective study of incontinence after repair operations.Surg Gynecol Obstet 1975;136:17–22

    Google Scholar 

  2. Cardozo L, Stanton SL. Genuine stress incontinence and detrusor instability: a review of 200 patients.Br J Obstet Gynaecol 1980;87:184–190

    Google Scholar 

  3. Jarvis GJ. An assessment of urodynamic examination in the incontinent woman.Br J Obstet Gynaecol 1980;87:893–896

    PubMed  Google Scholar 

  4. Mayne CJ, Hilton P. Short pad test: standardisation of method and comparison with 1-hour test.Neurourol Urodyn 1988:7:443–447

    Google Scholar 

  5. Versi E, Hyatt J, Anand D. Managing urinary incontinence in general practice.Diplomate 1994;1:12–17

    Google Scholar 

  6. Ramsay I, Ali HM, Heslington K, Hilton P. Can scoring the severity of symptoms help to predict the urodynamic diagnosis?Int Urogynecol J 1995;6:277–281

    Google Scholar 

  7. Benness CJ, Barnick C, Cutner A, Cardozo LD. Normal urodynamic findings in symptomatic women — who to believe, the patient or the test. Proceedings of 15th Annual International Urogynaecological Association, Stockholm, September 1990

  8. Hilton P. Urinary incontinence in women.Br Med J 1987;95:426–432

    Google Scholar 

  9. Massey A, Abrams P. Urodynamics of the female lower urinary tract.Urol Clin North Am 1985;12:231–236

    PubMed  Google Scholar 

  10. Bo K, Hagen R, Jorgensen J, Kvarstein B, Larsen S. The effect of two different pelvic floor muscle exercise programs in treatment of urinary stress incontinece in women.Neurourol Urodyn 1989;8:355–356

    Google Scholar 

  11. Wilson PD, Al Samarrai T, Deakin M, Kolbe E, Brown ADG. An objective assessment of physiotherapy for female stress incontinence.Br J Obstet Gynaecol 1987;94:575–582

    PubMed  Google Scholar 

  12. Jarvis GJ, Millar DR. Controlled trial of bladder drill for detrusor instability.Br Med J 1980;281:1322–1323

    Google Scholar 

  13. Pengelly AW, Booth CM, A prospective trial of bladder training as treatment for detrusor instability.Br J Urol 1980;52:463–466

    PubMed  Google Scholar 

  14. Frewen WK. Urge and stress incontinence: fact and fiction.Br J Obstet Gynaecol Br Commonw 1970;77:932–934

    Google Scholar 

  15. Holmes DM, Stone AR, Barry PR et al. Bladder training—3 years on.Br J Urol 1983;55:660–664

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gynaecology, Southern General Hospital, Glasgow, UK

    I. N. Ramsay, H. M. Ali, M. Hunter, D. Stark & K. Donaldson

Authors
  1. I. N. Ramsay
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  2. H. M. Ali
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  3. M. Hunter
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  4. D. Stark
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  5. K. Donaldson
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Additional information

EDITORIAL COMMENT: The treatment of urinary incontinence based on symptoms rather than urodynamic diagnosis has long been used by physicians, although the validity and success of this approach has been questioned. Dr Ramsay and associates attempt to address this issue of conservative management of urinary incontinence prior to urodynamic evaluation. The study design is clean cut, although the number of patients enrolled is small and the treatment regimen initially requires hospitalization. With more and more emphasis being placed on managed care, empiric therapy based on symptoms rather than the results of expensive urodynamic testing may become the standard approach to female urinary incontinence. Large randomized studies looking at clearly defined outcome measures will be necessary to support this approach.

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Ramsay, I.N., Ali, H.M., Hunter, M. et al. A randomized controlled trial of urodynamic investigations prior to conservative treatment of urinary incontinence in the female. Int Urogynecol J 6, 277–281 (1995). https://doi.org/10.1007/BF01901525

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  • DOI: https://doi.org/10.1007/BF01901525

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