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Open Access 28-03-2024 | Stress Incontinence | Original Article

Changes in Stress Urinary Incontinence Symptoms after Pelvic Organ Prolapse Surgery: a Nationwide Cohort Study (FINPOP)

Authors: Päivi K. Karjalainen, Anna-Maija Tolppanen, Olga Wihersaari, Kari Nieminen, Nina K. Mattsson, Jyrki T. Jalkanen

Published in: International Urogynecology Journal | Issue 4/2024

Abstract

Introduction and hypothesis

Various strategies are employed to manage stress urinary incontinence (SUI) during pelvic organ prolapse (POP) surgery. This study was aimed at facilitating shared decision-making by evaluating SUI symptom changes, staged SUI procedures, and their prognostic factors following POP surgery without concomitant SUI intervention.

Methods

We analyzed 2,677 POP surgeries from a population-based observational cohort, excluding patients with prior SUI surgery. The outcome measures were subjective SUI utilizing the Pelvic Floor Distress Inventory-20 questionnaire and number of subsequent SUI procedures. Multivariable linear models were applied to identify predictors of persistent SUI, procedures for persistent SUI, and de novo SUI. The primary assessment occurred at the 2-year follow-up.

Results

At baseline, 50% (1,329 out of 2,677) experienced SUI; 35% (354 out of 1,005) resolved, an additional 14% (140 out 1,005) improved, and 5.1% (67 out of 1,308) underwent a procedure for persistent SUI. De novo SUI symptoms developed in 20% (218 out of 1,087), with 3.2% (35 out of 1,087) reporting bothersome symptoms; 0.8% (11 out of 1,347) underwent a procedure for de novo SUI. High baseline symptom severity increased the risk of persistent SUI (adjusted odds ratio [aOR] 2.04, 95% confidence interval [CI] 1.65–2.53), whereas advanced preoperative apical prolapse decreased the risk (aOR 0.89, 95% CI 0.85–0.93). De novo SUI was more common with advancing age (aOR 1.03, 95% CI 1.01–1.05), baseline urgency urinary incontinence (aOR 1.21, 95% CI 1.06–1.38), and after transvaginal mesh surgery (aOR 1.93, 95% CI 1.24–3.00). It was not dependent on the compartment or preoperative degree of prolapse.

Conclusions

In a pragmatic setting, POP surgery results in a low rate of subsequent SUI procedures.

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Title: Changes in Stress Urinary Incontinence Symptoms after Pelvic Organ Prolapse Surgery: a Nationwide Cohort Study (FINPOP)
Authors: Päivi K. Karjalainen
Anna-Maija Tolppanen
Olga Wihersaari
Kari Nieminen
Nina K. Mattsson
Jyrki T. Jalkanen
Publication date: 28-03-2024
Publisher: Springer International Publishing
Keyword: Stress Incontinence
Published in: International Urogynecology Journal / Issue 4/2024
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-024-05760-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Changes in Stress Urinary Incontinence Symptoms after Pelvic Organ Prolapse Surgery: a Nationwide Cohort Study (FINPOP)

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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