The Prevalence and Risk Factors of Occult Stress Urinary Incontinence in Women Undergoing Genitourinary Prolapse Surgery
- Author:
Jibril AH
;
Ab Latip N
;
Ng PY
;
Jegasothy R
- Publication Type:Journal Article
- Keywords:
pelvic organ prolapse;
postoperative complications;
reconstructive surgical procedure;
stress urinary incontinence;
urodynamics
- MeSH:
Pelvic Organ Prolapse
- From:Journal of Surgical Academia
2016;6(1):10-17
- CountryMalaysia
- Language:English
-
Abstract:
De novo stress urinary incontinence (SUI) may occur in up to 80% of clinically continent women following
genitourinary prolapse surgery. This had resulted in an increase in the rate of concurrent continence surgery during
prolapse repair from 38% in 2001 to 47% in 2009 in the United States. To date, there is no local data available to
estimate the prevalence of occult SUI (OSUI) among Malaysian women awaiting surgery. Therefore, this study was
conducted to elicit the prevalence of occult SUI and its associated risks factors in patients awaiting prolapse surgery.
We retrospectively studied the records of 296 consecutive women with significant pelvic organ prolapse awaiting
reconstructive repair. All patients attended the Urogynaecology Unit in Hospital Kuala Lumpur Malaysia between
October 2007 and September 2011. They had undergone standardized interviews, clinical examinations and
urodynamic studies. During the urodynamic testings, all prolapses were reduced using ring pessaries to elicit OSUI.
Primary outcome was the prevalence of OSUI with prolapse reduction to predict possibility of developing de novo
SUI following prolapse surgery. Secondary outcome was the assessment of potential risk factors for OSUI. Among
the 296 women studied, 121 (40.9%) were found to have OSUI. The risk factors associated with OSUI included age,
BMI, numbers of SVD, recurrent UTI, reduction of urinary flow symptoms and grade 2 to 4 central compartment
prolapses. We concluded that preoperative urodynamic testing with reduction of prolapse is useful to identify women
with OSUI. This is important for preoperative counselling as well as planning for one step approach of prophylactic
concomitant anti-incontinence procedures during prolapse surgery in order to avoid postoperative de novo SUI.
- Full text:P020160607322630839466.pdf
