Has the use of preoperative urodynamics for stress urinary incontinence surgery changed following the VALUE study?

Aims To assess whether routine urodynamic testing (UDT) in women undergoing slings for uncomplicated stress urinary incontinence (SUI) has decreased following publication of the landmark VALUE study, which recommended against routine UDT in uncomplicated SUI. Methods We identified women in the Virgi...

Full description

Saved in:
Bibliographic Details
Published in:Neurourology and urodynamics 2020-08, Vol.39 (6), p.1824-1830
Main Authors: Clements, Matthew B., Zillioux, Jacqueline M., William Pike, Conner, Rapp, David E.
Format: Article
Language:English
Subjects:
Adult
Aged
Diagnostic Techniques, Urological
Female
Humans
Middle Aged
mid‐urethral slings
perioperative evaluation
Statistical analysis
stress urinary incontinence
Suburethral Slings
Surgery
Terminology
Urinary incontinence
Urinary Incontinence, Stress - physiopathology
Urinary Incontinence, Stress - surgery
urodynamics
Urodynamics - physiology
Urologic Surgical Procedures
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aims To assess whether routine urodynamic testing (UDT) in women undergoing slings for uncomplicated stress urinary incontinence (SUI) has decreased following publication of the landmark VALUE study, which recommended against routine UDT in uncomplicated SUI. Methods We identified women in the Virginia All Payers Claims Database diagnosed with SUI between 2011 and 2016 using International Classification of Disease (ICD) codes (N39.3, 625.6). Appropriate ICD/CPT (current procedural terminology) codes were used to exclude non‐index patients (prior anti‐incontinence/prolapse surgery, urge incontinence, neurogenic bladder). Beta regression was used to assess for changes in the monthly proportion of urethral slings with preoperative UDT. Interventional ARIMA modeling was used to assess for a relationship between the date of VALUE (The Value of Urodynamic Evaluation) publication and the incidence of slings with preoperative UDT. Results Analysis identified 6740 women with SUI undergoing sling placement, with 343 non‐index patients excluded. Of 6397 remaining women, 4026 (62.9%) underwent preoperative UDT. The annual number of slings with preoperative UDT declined from 748 to 402 between 2011 and 2016. Beta regression analysis demonstrated a decrease in the proportion of slings with preoperative UDT over the study (68%, 2011; 58%, 2016), with a statistically significant decrease in the proportion of slings with UDT after May 2012 (β coefficient, −.0093; P 
ISSN:0733-2467
1520-6777
DOI:10.1002/nau.24430