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- 저자 : Dipak Shaw (검색결과 1 건)
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Abhinav Agarwal,Sudheer Rathi,Pranab Patnaik,Dipak Shaw,Madhu Jain,Sameer Trivedi,Udai Shankar Dwivedi 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.12
Purpose: Urodynamic studies are commonly performed as part of the preoperativework-up of patients undergoing surgery for stress urinary incontinence (SUI). Weaimed to assess the extent to which these urodynamic parameters influence patientselection and postoperative outcomes. Materials and Methods: Patients presenting with SUI were randomly assigned to twogroups: one undergoing office evaluation only and the other with a preoperative urodynamicwork-up. Patients with unfavorable urodynamic parameters (detrusor overactivity[DO] and/or Valsalva leak point pressure [VLPP]<60 cm H2O and/or maximumurethral closure pressure [MUCP]<20 cm H2O) were excluded from the urodynamictesting group. All patients in both groups underwent the transobturator midurethralsling procedure. Evaluation for treatment success (reductions in urogenital distressinventory and incontinence impact questionnaire scoring along with absent positivestress test) was done at 6 months and 1 year postoperatively. Results: A total of 72 patients were evaluated. After 12 patients with any one or moreof the abnormal urodynamic parameters were excluded, 30 patients were finally recruitedin each of the “urodynamic testing” and “office evaluation only” groups. At boththe 6- and the 12-month follow-ups, treatment outcomes (reduction in scores and positiveprovocative stress test) were significantly better in the urodynamic testing groupthan in the office evaluation only group (p-values significant for all outcomes). Conclusions: Our findings showed statistically significantly better treatment outcomesin the urodynamic group (after excluding those with poor prognostic indicators suchas DO, low VLPP, and MUCP) than in the office evaluation only group. We recommendexploiting the prognostic value of these urodynamic parameters for patient counselingand treatment decisions.
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