📃 Paper Title: Urodynamics tests for the diagnosis and management of bladder outlet obstruction in men: the UPSTREAM non-inferiority RCT.
🧍 Author: Amanda L Lewis
🕒 Year: 2020
📚 Journal: Health Technology Assessments
🌎 Country: United Kingdom
ㅤContext to the study:
Can you tell me about a study which does not support the routine use of urodynamics in investigating men with LUTs?
ㅤ✅ Take-home message of study:
Investigation of bothersome lower urinary tract symptoms (LUTS) using urodynamics versus standard care results in a non-inferior improvement in symptoms at 18 months, and similar rates of surgery. Including urodynamics was more expensive. The results do not support the routine use of urodynamics to investigate men with LUTS.
ㅤ Non-inferiority randomised controlled trial
ㅤ
Study participants:
820 men randomised 1:1 to to receive urodynamics or not in their diagnostic pathway.
ㅤ
ㅤ
Key study outcomes:
International Prostate Symptom Severity Score (IPSS) at 18 months after randomisation - non-inferior
Rate of surgery - same in both groups (approx. ⅓)
Adverse events - same for both groups
Cost of treatment - urodynamics cost an additional £216
ㅤ
ㅤ
Study Limitations:
Follow up only 18 months, rate of surgery across whole study was lower than expected.
ㅤ