Women with ongoing urinary incontinence could avoid invasive bladder pressure tests, as new research shows that a number of non -invasive evaluations work equally well in the guidance of treatment.
Led by researchers at the University of Aberdeen, the findings of the future trial are presented today (Saturday 22 March 2025) at the European Union of Urology (EAU) conference in Madrid and published in the The Lancet.
The UK study is the first randomized controlled test in the clinic world and cost-effectiveness of urodynamics. It focuses on a group of women with specific types of bladder hyperactivity or encourages urine incontinence that do not respond well to initial treatments.
These front -line treatments include pelvic floor exercises, bladder re -education and drug treatments and referral to invasive urodynamic testing may determine if their condition is caused by a muscle overactive. The tests are recommended by the United Kingdom and European Guidelines, before invasive treatments such as the stimulation of the sacred nerve or variable toxin-A directly to the bladder wall.
For this group of women, the penetrating urodynamic test has been usually used in clinical practice for over 40 years. It assesses how well the bladder stocks and releases the urine and can be an unpleasant test for many. The tests include the filling of the bladder with water through a catheter inserted into the bladder. Another catheter is inserted into the vagina or rectum to measure pressures into the bladder and abdomen.
Integrated Clinical Assessment (CCA) for women’s incontinence is considered to reveal equally useful information to guidance of treatment without the need for invasive tests. The CCA includes a detailed medical questionnaire, a thorough physical examination, a bladder diary and a “cough test” to evaluate stress incontinence. It may also include urine analysis and a test to measure the amount of urine left in the bladder after urination.
To determine whether the urodynamics test would lead to patients who reported successful results from their treatment, compared to the therapeutic plans guided by CCA, the future test was hired 1099 women in 63 United Kingdom Hospitals.
Women were included in the test whether they had excessive bladder or urinary incontinence, which was mainly characterized by a sudden urgent need to urinate, which did not respond to front -line treatments. Participants were randomized either to undergo an invasive urodynamic test plus a CCA, or only one CCA.
During a 15-24-month monitoring period, participants were invited to report the success of the treatment offered. The test did not find a significant difference between the two forms of evaluation, with 23.6% of women reporting that their symptoms were “very” and “much” improved to the Urodynamics group against 22.7% in the CCA group – showing that both evaluations provide similar results to patients.
Women who only underwent CCA also reported previous improvement in their symptoms. 13% of women undergoing urodynamics had changed their diagnosis to urodynamic stress and their therapeutic plan changed accordingly.
Researchers indicate that clinical doctors can now be more selective to determine who will refer to invasive urodynamics.
Invasive urodynamics tests can be annoying and unpleasant procedures. For many women struggling to find a treatment that works for this type of urinary incontinence, our test shows that they no longer need to go through this experience to achieve improved symptoms and quality of life.
While women undergoing invasive urodynamics tests received more customized treatments based on the effect of the test, this was not translated into better success rates reported by patients after therapies, better improved quality of life of women or less unwanted actions.
It is clear that in this group of women, integrated clinical evaluations provide plenty of information to help design a successful treatment plan for those who do not respond to front -line treatments and thus clinical doctors can be much more selective about who is referred to urodynamics. “
Professor Mohamed Abdel-Fattah, head of researcher, director of Aberdeen Center for Women’s Health Center for Health, Aberdeen University
A CCA can be performed by a special nurse or hospital doctor and does not require specialized equipment. Invasive urodynamic tests, however, include referral to a special clinic, including various personal and dedicated equipment and may mean that you wait many weeks or months to see.
Following a financial assessment, the researchers concluded that the urodynamics test for this group of women was not a value for money, based on the National Institute of Excellence and Excellence Costs of £ 20,000 per additional year of good health.
Commenting on the results of the future trial, Professor Benoit Peyronnet, Professor at the Urology Department at Rennes University, France and member of the EAU Scientific Congress Office, said: “Many European countries have long waiting lists for uncertainty and uncertainty tests. The results for women – based on their own references to whether their treatment is successful – could be just as good.
“However, in busy clinical arrangements, there may be no time to take on the order of integrated evaluations carried out in the future test, so invasive urodynamics tests can be valuable and important in certain arrangements-and especially in some patient groups.
The future trial was funded by the Health and Health Care and Care Program. A five-year monitoring test that evaluates the long-term results and the cost-efficacy of Urodynamics is ongoing by the researchers.
Source:
Magazine report:
Abdel-Fattah, M., et al. (2025). Invasive urodynamic studies in the management of women with durable bladder hyperactivity symptoms (future) in the United Kingdom: a multicenter, superiority, parallel, open, randomized controlled test. The Lancet. Doi.org/10.1016/s0140-6736(24)).
