Predictors for de novo stress urinary incontinence following extensive pelvic reconstructive surgery
Introduction and hypothesis The aim of this study was to lookfor possible predictors preoperatively for the development of de novo stress urinary incontinence (SUI) in urodynamically continent women who underwent pelvic reconstructive surgery(PRS). Materials and methods Medical records of 637 conti...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English English |
| Published: |
Springer London
2015
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/44019/ http://irep.iium.edu.my/44019/ http://irep.iium.edu.my/44019/ http://irep.iium.edu.my/44019/4/predictors_for_de_novo.pdf http://irep.iium.edu.my/44019/7/44019_Predictors%20for%20de%20novo%20stress%20urinary%20incontinence%20following%20extensive%20pelvic%20reconstructive%20surgery_SCOPUS.pdf |
| Summary: | Introduction and hypothesis The aim of this study was to lookfor possible predictors preoperatively for the development of de novo stress urinary incontinence (SUI) in urodynamically continent women who underwent pelvic reconstructive surgery(PRS).
Materials and methods Medical records of 637 continent
women who underwent PRS for severe prolapse from
January 2005 to December 2013 in our institutions were includedin this study. We excluded women who had
urodynamic stress incontinence (UDI) either occult or overt,
detrusor overactivity, neurogenic bladder-voiding dysfunction,and previous anti-incontinent surgery. Primary outcome measure was the development of de novo SUI at 6 months to 1 year post operation.
Results Of women in this study, 11 % developed postoperative
de novo SUI at 6 months to 1 year of follow-up. Women
older than 66 years were 2.86 times [95 % confidence interval(CI) 1.01–2.53, p=0.14], diabetes mellitus (DM) 2.18 times(95 % CI 1.63–4.21, p=0.002), certain type of transvaginal mesh procedure 3.5 times (95 % CI, p<0.001), maximum urethral closure pressure (MUCP)<60 mmH20 4.65 times
(95 %CI, 2.87–8.64, p<0.001), and functional urethral length
(FUL)<2 cm 3.48 times (95 % CI, 2.13–5.83, p<0.001) at
greater risk of developing de novo SUI.
Conclusions Continent women with advanced pelvic organ
prolapse (POP)>66 years, with DM or low MUCP and FUL
values during preoperative urodynamic evaluation have
higher risk of developing de novo SUI; therefore, we suggest
counselling such women for concomitant PRS and antiincontinent surgery. |
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