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NICE guidelines could lead to poor outcomes from stress urinary incontinence surgery

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Women may not benefit from surgery to treat stress urinary incontinence if NICE guidelines on use of urodynamic investigation are followed.

This is the conclusion of researchers from the Bristol Urological Institute who evaluated the potential impact of the NICE recommendation thatpreoperative urodynamics are not necessary for women with pure symptoms of stress urinary incontinence.

They retrospectively analysed the history of 6276 women with UI who had multichannel cystometry between 1990 and 2006.

Only 324 (5.2%) women had pure stress urinary incontinence and a quarter of these had other conditions diagnosed by urodynamic investigations that could affect the outcome of continence surgery.

The authors suggest that only a small group of women fulfil the NICE criteria of pure SUI and the criteria do not ensure that women with potentially important urodynamic findings are evaluated. They suggest that this ‘NICE recommendation was unwise and was not based on properly acquired expert opinion’.

British Journal of Urology International 2008 Nov 18.PMID: 19021606

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