Urodynamic investigations for management of urinary incontinence in adults

Urodynamic tests are used to investigate people who have urinary incontinence or other urinary symptoms in order to make a definitive objective diagnosis. The aim is to help to select the treatment most likely to be successful. The investigations are invasive and time consuming.

The objective of this review was to discover if treatment according to a urodynamic-based diagnosis led to clinical improvements in urinary incontinence, compared to treatment based on history and examination.

We searched the Cochrane Incontinence Group trials register. Date of the most recent search: April 2002.

Randomised and quasi-randomised trials comparing clinical outcomes in groups of people who were and were not investigated using urodynamics, or comparing one type of urodynamics against another.

Two reviewers independently assessed trial quality and extracted data. Authors of one study were contacted for more information, including adverse effects.

Two small trials involving 128 women were included. In one small trial, women who were investigated with urodynamics were more likely to receive active treatment with drugs or surgery. However, the numbers in both trials were too small to determine if this affected clinical outcomes such as a reduction in incontinence.

A larger definitive trial is needed, in which people are randomly allocated to management according to urodynamic findings or to standard management based on history and clinical examination.