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Title: Assessing professional equipoise and views about a future clinical trial of invasive urodynamics prior to surgery for stress urinary incontinence in women: a survey within a mixed methods feasibility study.
Authors: Hilton, Paul
Bryant, Andy
Howel, Denise
McColl, Elaine
Buckley, Brian S.
Lucas, Malcolm
Tincello, Douglas G.
Armstrong, Natalie
First Published: 28-Sep-2012
Publisher: Wiley-Blackwell on behalf of the International Continence Society and the Society for Urodynamics and Female Urology
Citation: Neurourology and Urodynamics, 2012, 31 (8), pp. 1223-1230.
Abstract: Aims: To determine surgeons' views on invasive urodynamic testing (IUT) prior to surgery for stress (SUI) or stress predominant mixed urinary incontinence (MUI). Methods: Members of British Society of Urogynaecology (BSUG) and British Association of Urological Surgeons Section of Female, Neurological and Urodynamic Urology (BAUS-SFNUU) were sent an email invitation to complete an online “SurveyMonkey®” questionnaire regarding their current use of IUT prior to surgical treatment of SUI, their view about the necessity for IUT in various clinical scenarios, and their willingness to randomize patients into a future trial of IUT. A purposive sample of respondents was invited for telephone interview to explore further how they use IUT to inform clinical decisions, and to contextualize questionnaire responses. Results: There were 176/517 (34%) responses, 106/332 (32%) from gynecologists/urogynecologists and 67/185 (36%) from urologists; all respondents had access to IUT, and 89% currently arrange IUT for most women with SUI or stress predominant MUI. For a variety of scenarios with increasingly complex symptoms the level of individual equipoise (“undecided” about IUT) was very low (1–6%) and community equipoise was, at best, 66:34 (IUT “essential” vs. “unnecessary”) even for the simplest scenario. Nevertheless, 70% rated the research question underlying the proposed studies “very important” or “extremely important;” 60% recorded a “willingness to randomize” score ≥8/10. Conclusions: Most urogynecologists and urologists consider IUT essential before surgery in SUI with or without other symptoms. Most however recognize the need for further research, and indicated a willingness to recruit into multicenter trials addressing this question.
DOI Link: 10.1002/nau.22328
ISSN: 0733-2467
eISSN: 1520-6777
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2012 Wiley Periodicals, Inc. This article is published under the Online Open option, which permits posting of the published PDF on the author's institutional repository immediately on publication. The definitive version is available at
Appears in Collections:Published Articles, Dept. of Health Sciences

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