Table 6.

All potential facilitators and barriers possibly related to performing routine urodynamics (UDS) in the preoperative phase for women with stress urinary incontinence (SUI) destilated by semistructured interviews

Domain 1 Characteristics of VUSIS-II and ValUE study results	Domain 2 Professional characteristics	Domain 3 Patient characteristics	Domain 4 Context characteristics	Domain 5 Urodynamic investigation characteristics
Outcome of the VUSIS study (F) Recommendation of the VUSIS not to routinely perform UDS (F) I (do not) like the design of the VUSIS study (F/B)	The combination of voiding diary, uroflow/ postvoid residual volume and physical examination gives me enough information (F) I do not trust on UDS (F) If there might be an OAB component I’ll first treat with anticholinergics and do not need UDS (F) I think the importance of UDS are wide (B) UDS gives me evidence of stress incontinence (F) I think UDS are a forced examination (F) USD seem an unpleasant examination to me (F) I think performing UDS can be harmful (e.g., getting an UTI) I am used to perform urodynamics all my carrier (B) For counseling the patient regarding postoperative expectations I use urodynamic findings (B) I have to perform urodynamics myself (F)	I cannot apply these study results in daily practice because I treat another patient population (B) Patients feel UDS as stressful (F) Elderly patients (B) Neurological illness (B) Not belonging to “normal” SUI group (nulliparous, young women) (B) Unreliable patients in history (B) Predominance of SUI is less pronounced (B) Patients who not fill in/able to fill in their voiding diary (B) Unreliable voiding diary (B) Physical examination gives doubts to cause of incontinence (B) Large residue or poor flow (B)	The latest national guideline regarding urinary incontinence (F/B) Logistics without routinely UDS are faster (F) Logistics with routinely UDS are optimally regulated (B) It’s easier not to perform urodynamics (F) Performing UDS provides more work (F) There is less pressure on the equipment when you perform less UDS (F) To be stronger in claims I find evidence obtained by UDS usefull (B) promotes the cooperation between gynecologists and urologists (B) Cost effectiveness (F/B)	UDS are additional value to me to know if there is detrusor overactivity or reduced transmission or intrinsic sphincter deficiency (B) Uncertainty about the value or way of performing UDS (F) No demonstrable stress incontinence on UDS helps me in the decision to perform surgery (B) A low MUCP or low LPP on UDS could lead to a different treatment or a referral to a colleague (B)

VUSIS-II and ValUE Value of Urodynamics prior to Stress Incontinence Surgery, ValUE Value of Urodynamic Evaluation, F facilitator, B barrier, UTI urinary tract infection, MUCP maximal urethral closure pressure, LPP leak-point pressure, OAB overactive bladder