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408 - PURE STRESS URINARY INCONTINENCE: PREVALENCE, COSTS AND FINANCIAL IMPACT

408

PURE STRESS URINARY INCONTINENCE:PREVALENCE, COSTS AND FINANCIAL IMPACT

E. RUBILOTTA1, M.BALZARRO 1, M. CERRUTO 1, A. PORCARO 1,S. BASSI 1, P. CORSI 1, M. PIROZZI 1,N. TRABACCHIN 1, C. BOVO 2, W. ARTIBANI 1;
1Urology, AOUI Verona, Verona, Italy, 2DirezioneSanitaria, AOUI Verona, Verona, Italy.

Introduction: Prevalence andUrodynamic (UD) test indications of pure stress urinary incontinence(P-SUI) is still a controversial subject1,2.
Objective:To evaluate prevalence, urodynamic associations and related costs ofP-SUI in patients with Urinary Incontinence (UI).
Methods:We retrospectively evaluated 544 women with UI between January 2012and July 2016. P-SUI was defined by the International ContinenceSociety (Table 1).
The study evaluated:
- Prevalence ofclinical and UD P-SUI
- Correspondence between clinical P-SUI andUD findings
- Accurate estimation (€) of a single UDexamination, including human resources and materials
- Totalamount of UD costs
- Number of surgical procedures avoided due toUD results
- Related avoided surgical costs
Results: SUIwas present in 59.4% (323/544), in this group the prevalence of P-SUIwas 20.7% (67/323) while the prevalence of complicated SUI was 79.3%(256/323). The correspondence between the clinical diagnosis of P-SUIand UD findings was 88% (59/67 patients). As a consequence diagnosisof P-SUI decreased to 18.3% (59/323 cases). The cost of each UD studywas 383 € and the total amount for the entire cohort was 25.661 €.So far, the scheduled middle urethral sling (MUS) was avoided in 6patients because of UD results and the total amount saved was 10.800€.
Conclusions: In SUI women, P-SUI prevalence was 1/5 asassessed by UD. There was a high correspondence between clinical andUD findings. UD avoided an inappropriate procedure in 9% ofcases.
References: - 1. Nager CW, Brubaker L, Litman HJ,Zyczynski HM, Varner RE, Amundsen C, Sirls LT, Norton PA, Arisco AM,Chai TC, Zimmern P, Barber MD, Dandreo KJ, Menefee SA, Kenton K,Lowder J, Richter HE, Khandwala S, Nygaard I, Kraus SR, Johnson HW,Lemack GE, Mihova M, Albo ME, Mueller E, Sutkin G, Wilson TS, Hsu Y,Rozanski TA, Rickey LM, Rahn D, Tennstedt S, Kusek JW, Gormley EA;Urinary Incontinence Treatment Network. A randomized trial ofurodynamic testing before stress-incontinence surgery. N Engl J Med.2012 May 24;366(21):1987-97.
- 2. Serati M, Topazio L, Bogani G,Costantini E, Pietropaolo A, Palleschi G, Carbone A, Soligo M, DelPopolo G, Li Marzi V, Salvatore S, Finazzi Agro E. Urodynamicsuseless before surgery for female stress urinary incontinence: Areyou sure? Results from a multicenter single nation database.Neurourol Urodyn. 2016 Sep;35(7):809-12.

Table1: International Continence Society Criteria for Pure SUI

Inclusioncriteria

Exclusioncriteria

  • 21years old

  • Stresspredominant urinary incontinence

  • Historyof symptoms of stress urinary incontinence for at least 3 months

  • PVRV< 150 ml

  • Negativeurinalysis or urine culture

  • Clinicalassessment urethral mobility

  • Desireof surgery

  • Pain

  • Haematuria

  • Recurrentinfections

  • Voidingsymptoms

  • Pelvicirradiations

  • Radicalpelvic surgery

  • Suspectedfistula