Is there a link between preoperative fluoroscopic cough stress testing and synthetic midurethral tape outcome?

OBJECTIVES - The primary aim of our study was to assess the utility of fluoroscopic cough stress testing as a predictor of synthetic midurethral tape (MUT) outcome. The secondary aim was to examine whether baseline demographics, clinical symptoms and urodynamic variables could predict MUT success.

STUDY DESIGN - We carried out a retrospective study including women with stress urinary incontinence (SUI) who underwent retropubic MUT in a tertiary referral urogynaecology unit. We excluded cases where concurrent pelvic organ prolapse surgery was performed. Patients were subdivided into groups based on the pre-operative fluoroscopic cough stress testing, using Blaivas and Versi classifications. Subjective outcome was evaluated at 6 weeks based on self-reported SUI in the symptom domain of the King's Health Questionnaire. Logistic regression models were used to identify predictors of treatment success.

RESULTS - 143 patients were included in the study. Blaivas and Versi classifications were not useful in predicting subjective success (p=0.44 and p=0.40, respectively). Baseline demographics, clinical and other urodynamic variables failed to predict subjective outcome.

CONCLUSIONS - Fluoroscopic cough stress testing is not a useful predictor of MUT outcome. No preoperative variables have been found to predict MUT success.

Eur J Obstet Gynecol Reprod Biol. 2015 Jul 17;193:61-64. doi: 10.1016/j.ejogrb.2015.07.002. [Epub ahead of print]

Zacchè MM1, Giarenis I2, Thiagamoorthy G2, Robinson D2, Cardozo L2.

1 Department of Urogynaecology, King's College Hospital, London, UK.
2 Department of Urogynaecology, King's College Hospital, London, UK.