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

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.

RESULTS: 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).

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

Written by:
Kawasaki A, Wu JM, Amundsen CL, Weidner AC, Judd JP, Balk EM, Siddiqui NY. Are you the author?
Department of Obstetrics & Gynecology, Division of Urogynecology, Duke University Medical Center, 5324 McFarland Drive, Suite 310, Durham, NC, 27707, USA.

Reference: Int Urogynecol J. 2012 Mar 9. Epub ahead of print.
doi: 10.1007/s00192-012-1693-3

PubMed Abstract
PMID: 22402639

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