NE-AUA 2006 Annual Meeting, September 28 - 30, 2006, The Westin Hotel & Rhode Island Convention Center Providence, Rhode Island
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The Role of Videourodynamics in Assessment of Stress Urinary Incontinence and its Impact on Choice of Surgical Modality
Daniel M. Kaplon, MD, Young Kim, MD.
Brown University, Providence, RI,

Background: Our purpose is to assess the role of fluoroscopy as an adjunct to a conventional urodynamic evaluation in influencing the type of surgical management employed for stress urinary incontinence (SUI). The role of videourodynamics remains unclear in the current literature.
Methods: We retrospectively reviewed 182 videourodynamic studies performed in 182 patients presenting with SUI between July 1997 and July 2000 to determine if fluoroscopic evaluation influenced the ultimate management decision.
Results: Of the 182 patients studied, only 6 (3%) had fluoroscopic findings that directly influenced surgical management. In all 6 cases, the ability to distinguish ISD from urethral hypermobility allowed for a decision between retropubic suspension and pubovaginal sling in women less than 40 years old presenting with severe stress incontinence.
Conclusion: Our data demonstrates little role for the use of fluoroscopy in the initial evaluation of stress urinary incontinence. Given that the standard of care for all types of SUI has become the midurethral sling, the ability to distinguish ISD from urethral hypermobility on fluoroscopy has little impact on initial surgical decision making. The only situation in which it may still be useful is in diagnosing ISD in patients who are to undergo transabdominal hysterectomy concurrently with an operation for incontinence. Only in these patients would a transabdominal suspension be considered.


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