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International Urogynecology Journal

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01-01-2013 | Original Article

Which women develop urgency or urgency urinary incontinence following midurethral slings?

Authors: Joseph K-S Lee, Peter L. Dwyer, Anna Rosamilia, Yik N. Lim, Alexander Polyakov, Kobi Stav

Published in: International Urogynecology Journal | Issue 1/2013

Abstract

Introduction and hypothesis

De novo urgency has a negative impact on women after midurethral sling (MUS). We aimed to identify risk factors for de novo urgency (dU) and urgency urinary incontinence (dUUI) following MUS, using multivariate analysis.

Methods

We investigated 358 consecutive women with only stress urinary incontinence (SUI) [or urodynamic stress incontinence (USI)] and 598 women with both SUI (or USI) and urgency (but not UUI) who underwent MUS with a mean follow-up of 50 months. Women who developed dU or dUUI at long-term follow-up were compared to those who did not.

Results

dU occurred in 27.7 % (99/358) and dUUI occurred in 13.7 % (82/598) of women at long-term follow-up after midurethral sling. Intrinsic sphincter deficiency {odds ratio (OR) dU 3.94 [95 % confidence interval (CI) 1.50–10.38]; OR dUUI 2.5 (1.31–4.80)}, previous stress incontinence surgery [sling: OR dU 3.69 (1.45–9.37); colposuspension: OR dUUI 2.5 (1.23–5.07)], previous prolapse surgery [OR dU 2.45 (1.18–5.10)], preexisting detrusor overactivity [OR dU 1.99 (1.15–3.48); OR dUUI 1.85 (1.31–2.60)] increased the risk, whereas performing concomitant apical prolapse surgery [OR dU 0.5 (0.41–0.81); OR dUUI 0.29 (0.087–0.97)] significantly decreased the risk. Women are more likely to not recommend surgery when they experienced dU (18.2 vs 0.8 %, p < 0.0001) or dUUI (20.7 vs 2.1 %, p < 0.0001).

Conclusions

Urodynamic parameters, history of prior incontinence or prolapse surgery and concomitant apical prolapse operation were important predictors of dU or dUUI following MUS.

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Title: Which women develop urgency or urgency urinary incontinence following midurethral slings?
Authors: Joseph K-S Lee
Peter L. Dwyer
Anna Rosamilia
Yik N. Lim
Alexander Polyakov
Kobi Stav
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 1/2013
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-012-1844-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Which women develop urgency or urgency urinary incontinence following midurethral slings?

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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