Expensive Bladder Test Not Needed

Office visits alone suffice for urinary incontinence surgery

(RxWiki News) Many women suffer from urinary incontinence, or a loss of bladder control. For severe cases, surgery can help. A recent study reports that an invasive and expensive test given to women before surgery may not be needed.

Researchers for the Urinary Incontinence Treatment Network (UITN) tracked 630 women and found that women who didn’t receive bladder testing were just as likely to receive successful treatment, compared to women who did receive testing.

"Painful testing isn’t necessary before UI surgery."

Urinary incontinence affects roughly 13 million Americans, and women are at greater risk for the condition. Pregnancy, childbirth, changes with aging and hysterectomy are a few causes of the condition.

Some sufferers occasionally leak urine after coughing or sneezing while others have sudden, strong urges to urinate and are unable to hold their urine before reaching a toilet.

To treat the condition, doctors may recommend medication; behavioral techniques, such as bladder training; or physical therapy, including Kegel exercises, which are exercises to strengthen the urinary sphincter and pelvic floor muscles.

If these treatments fail, surgery might be necessary, which may require additional testing, including urodynamic testing, in which a catheter is inserted into the urethra and bladder to fill the bladder with water.

The study, funded by the National Institutes of Health, looked at questionnaire answers from women with stress urinary incontinence at different research centers.

Researchers gave half of the women an office check-up before the surgery and bladder function testing. The other half of the women receive an office-check up only.

The researchers found that surgery success was equal among the groups: 76.9% in the bladder testing group and 77.2% in the non-bladder-testing group.

Surgical treatment was considered successful if a woman’s urinary distress was reduced by 70% or more and her condition had improved “much” or “very much” after one year, according to the researchers.

The authors note that the women reported no differences in the quality of life, patient satisfaction or voiding dysfunction, a problem that occurs when a person is unable to empty the bladder fully.

The tests – which are pricey, uncomfortable and could lead to urinary tract infections – did not provide any added benefit for surgical treatment success, says lead study author Dr. Charles Nager, director of urogynecology and reconstructive pelvic surgery at the University of California, San Diego.

This study was posted on the New England Journal of Medicine's website and will publish in the journal’s print edition on May 24.

Review Date: 
May 3, 2012