This week the Female Urgency, Trial of Urodynamics as Routine Evaluation (FUTURE) study was publised in the LANCET. Professor Abdel-Fattah who led the study shared the below.
The FUTURE study is probably the largest study worldwide in the field of assessment of urinary incontinence in women. It focuses on groups of women who have overactive bladder incontinence. These women currently have to undertake an invasive set of tests (called Urodynamics) for assessment prior to them being considered for second line treatments such as Botox or Sacral nerve stimulation. Urodynamics are considered as specialist tests with burden on the NHS resources and relatively long waiting lists. Women told us the tests are embarrassing, invasive, and can be painful and/or cause emotional stress, however they will undertake it if they can improve their treatment outcomes.
Just over 1100 women from 63 hospitals in the UK volunteered and took part in the FUTURE study. They were assigned by random to either undertake a comprehensive clinical assessment only or with Urodynamics tests. From our results it’s clear that in this cohort of women, comprehensive clinical assessments alone provide enough information to help design equally successful treatment plans compared to those under Urodynamics. In-addition, women in the clinical assessment group started feeling improvements in their symptoms and quality of life earlier as they did not have to wait for the test (which can take from a few months to a year in some hospitals).
In the real world our results mean that women with overactive bladder incontinence can now progress to treatments such as Botox after comprehensive clinical assessment only. Women will start experiencing improvement in their symptoms and quality of life earlier, they will avoid the long waiting lists for Urodynamics and avoid potentially embarrassing and painful invasive tests. Our results can lead to significant cost savings to the NHS.
On behalf of the FUTURE Study Team, I would like to thank all 1103 women who volunteered to be part of the study and the 63 centres who participated. We also thank National Institute of Health Research (HTA program) who funded the study and the chairs/ members of the independent trial steering and data monitoring committees.
You can read the publication here: Invasive urodynamic investigations in the management of women with refractory overactive bladder symptoms (FUTURE) in the UK: a multicentre, superiority, parallel, open-label, randomised controlled trial - The Lancet