Are urodynamics needed before surgery for straightforward female stress incontinence?

For straightforward cases of SUI, a noninvasive evaluation establishes the diagnosis, and the discovery of urodynamic detrusor overactivity would not change the surgical plan. ISD would change the plan for a transobturator sling but not a retropubic mid urethral sling or fascial sling. Detrusor underactivity would change patient counseling about urinary retention but exact correlations between urodynamic measures and risk of retention are lacking. Discovery of poor compliance would change the plan but this is extremely rare in straightforward SUI. Therefore, overall, urodynamics are not needed before surgery for straightforward SUI.