An invasive and costly test commonly performed in women before surgery for stress urinary incontinence was shown to be unnecessary.

A study funded by the US National Institutes of Health (Bethesda, MD, USA) compared results after both a preoperative check-up in a doctor’s office and bladder function tests to results after only the office check-up. Women who had only the office check-up had equally successful outcomes after surgery.

Moreover, called urodynamic studies, bladder function tests help assess how well the bladder, sphincter muscles, and urethra store and release urine. The insertion of catheters and filling the bladder until full as required by some of the tests can be very uncomfortable or even painful for many women. The average cost is approximately USD 500.

In the study, half of 630 women with uncomplicated stress urinary incontinence had a preoperative office check-up and bladder function testing. The other half had only an office check-up. Treatment success was similar in both groups, 76.9% versus 77.2%, respectively, with no significant differences in quality of life, patient satisfaction, or voiding dysfunction, the inability to empty the bladder completely.

“Bladder function tests are often performed before surgery in women who demonstrate stress incontinence upon office evaluation,” said study lead author Charles Nager, MD, director of urogynecology and reconstructive pelvic surgery at the University of California, San Diego, USA. “The findings of our study argue against routine preoperative testing in cases of uncomplicated stress urinary incontinence, as the tests provide no added benefit for surgical treatment success but are expensive, uncomfortable, and may result in complications such as urinary tract infections.”

Results of the study, performed by the Urinary Incontinence Treatment Network (UITN), are posted on the New England Journal of Medicine (NEJM) website (please see Related Links below) and published in the journal's print issue. The UITN is a group of urologists and urogynecologists from all over the country who are conducting research on the treatment of urinary incontinence, or accidental loss of urine.

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