Non-invasive bladder tests reliable for diagnosing female incontinence: Study

New Delhi: Non-invasive bladder tests for women with urinary incontinence are just as effective as invasive methods, according to new research published in The Lancet on Saturday.

The study, led by Professor Mohamed Abdel-Fattah at the University of Aberdeen, Scotland, highlights that women experiencing ongoing urinary incontinence or overactive bladder—a condition marked by a sudden, uncontrollable urge to urinate—may no longer need to undergo uncomfortable and often embarrassing invasive bladder pressure assessments known as urodynamics testing.

Urodynamics testing, routinely used in clinical practice for over four decades, involves filling the bladder with water through a catheter inserted into the bladder. Additionally, a second catheter is placed into the vagina or rectum to measure pressure within the bladder and abdomen. Many women find this procedure invasive, distressing, and uncomfortable.

The research suggests that a simpler alternative, known as Comprehensive Clinical Assessment (CCA), provides equally reliable insights without invasive measures. The CCA method includes a detailed medical questionnaire, thorough physical examination, a bladder diary maintained by the patient, and a cough test designed to assess stress-related urinary leakage. Additionally, it may involve urinalysis and ultrasound evaluation to measure residual urine volume after urination.

Professor Abdel-Fattah, Director of the Aberdeen Centre for Women’s Health Research, said, "Invasive urodynamics tests can be embarrassing and uncomfortable procedures. Our trial shows women struggling to find effective treatment no longer need to endure invasive testing to significantly improve symptoms and quality of life."

To assess both approaches, the researchers recruited 1,099 women with urinary incontinence or overactive bladder symptoms from 63 hospitals across the UK. Participants were randomly divided into two groups: one undergoing invasive urodynamics testing alongside CCA, and the other group receiving only CCA.

During the 15- to 24-month follow-up, the study revealed no significant difference in symptom improvement between the two groups. Approximately 23.6% of women undergoing urodynamics reported their symptoms had improved 'very much' or 'much', compared to 22.7% in the CCA-only group.

Additionally, women who received only the non-invasive CCA method reported earlier improvement in their symptoms. Interestingly, in about 13% of cases where invasive testing was used, diagnoses changed to urodynamic stress incontinence, leading to altered treatment plans.

Based on these findings, researchers recommend clinicians reconsider the routine use of invasive testing, suggesting they become more selective about referring patients for urodynamics.

The study's results indicate significant potential to simplify diagnosis and treatment planning, improving the overall experience and quality of care for women with urinary incontinence.