MP63-13 DOES VIDEOURODYNAMIC CLASSIFICATION DEPEND ON PATIENT POSITIONING IN PATIENTS WITH STRESS URINARY INCONTINENCE?

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Incontinence: Evaluation (Urodynamic Testing)1 Apr 2017MP63-13 DOES VIDEOURODYNAMIC CLASSIFICATION DEPEND ON PATIENT POSITIONING IN PATIENTS WITH STRESS URINARY INCONTINENCE? Hazel Ecclestone, Eskinder Solomon, Rizwan Hamid, Mahreen Paksad, Daniel Wood, Tamsin Greenwell, and Jeremy Ockrim Hazel EcclestoneHazel Ecclestone More articles by this author , Eskinder SolomonEskinder Solomon More articles by this author , Rizwan HamidRizwan Hamid More articles by this author , Mahreen PaksadMahreen Paksad More articles by this author , Daniel WoodDaniel Wood More articles by this author , Tamsin GreenwellTamsin Greenwell More articles by this author , and Jeremy OckrimJeremy Ockrim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1965AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Videourodynamic studies (VUDS) are often used to assess stress urinary incontinence (SUI). Treatment options are based on the degree of hypermobility and intrinsic sphincter deficiency. The most common classification on VUDS of SUI by Blaivas-Olsson is described in the semi-oblique position. However, most urodynamics are performed supine or standing with advocates of standing position suggesting that this stance permits gravity to enhance prolapse and aid diagnosis. We assessed the difference in Blaivas-Olsson grading in either positions. METHODS 121 consecutive women with SUI underwent videourodynamic study prior to operative intervention. SUI was assessed in both supine and standing positions and the extent of descent was classified according to Blaivas-Olsson criteria. Differences between the positions was assessed using Fisher's exact test with p <0.05 being significant. RESULTS 72 of 121 SUI classifications remained the same in both lying and standing positions. 49 gradings were upgraded with position (40%); no patients were downgraded. Of the 49 patients whose grading changed, 20 (16.5%) had non-demonstrable SUI converted to demonstrable (i.e. grade 0 converted to I, IIa, IIb or III); 22 patients with SUI in the supine position were upgraded by one grade (I -IIa (10) and IIa-IIb (12)) and 7 were upgraded by two grades from I to IIb (Figure). The difference in the distribution of SUI grading between supine and standing positions was statistically significant (p < 0.01) CONCLUSIONS 16.5% of patients only had SUI demonstrable in the standing position. 40% Blaivas-Olsson classifications were upgraded with patients in the standing position. This has important implications for practice. To best replicate symptoms, and minimise the chance of underestimating both incontinence and the degree of descent, we suggest that videourodynamics are performed using standardised methodology in both lying and standing positions. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e840 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Hazel Ecclestone More articles by this author Eskinder Solomon More articles by this author Rizwan Hamid More articles by this author Mahreen Paksad More articles by this author Daniel Wood More articles by this author Tamsin Greenwell More articles by this author Jeremy Ockrim More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...