Abstract
Introduction and hypothesis
We hypothesized that certain preoperative voiding symptoms would be correlated with poorer post-continence surgery outcomes in women.
Methods
Preoperative voiding symptoms from 655 women were assessed with questionnaires. Outcomes (overall failures, stress-specific failures, and voiding dysfunction) after Burch or sling surgery were measured. Logistic regression models were used to associate preoperative voiding symptoms with postoperative outcomes.
Results
Hesitating urinary stream was associated with voiding dysfunction [OR 2.22, p = 0.01], overall [OR 1.57, p = 0.03], and stress-specific [OR 1.67, p = 0.009] failures. A ten-point increase in preoperative Urogenital Distress Inventory-obstructive (UDI-O) subscore was associated with overall [OR 1.10, p = 0.049] and stress-specific [OR 1.21, p < 0.0001] failures. Even controlling for severity of POPQ stage, significant associations of hesitating urinary stream with voiding dysfunction, overall and stress-specific failures remained.
Conclusions
Preoperative hesitating urinary stream and obstructive voiding symptoms were associated with poorer surgical outcomes. Further studies in this area may be fruitful.
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Acknowledgement
This study was supported by NIH U01 DK58225, U01 DK58229, U01 DK58234, U01 DK58231, U01 DK60379, U01 DK60380, U01 DK60393, U01 DK60395, U01 DK60397, and U01 DK60401.
Conflicts of interest
Linda Brubaker is a consultant for Pfizer. Gary E. Lemack is a researcher and consultant for Pfizer, a researcher for Allergan, and received honoraria from Astellas. Toby C. Chai is a consultant for and received honoraria from Pfizer and Astellas and is a researcher for Allergan.
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Sanses, T.V., Brubaker, L., Xu, Y. et al. Preoperative hesitating urinary stream is associated with postoperative voiding dysfunction and surgical failure following Burch colposuspension or pubovaginal rectus fascial sling surgery. Int Urogynecol J 22, 713–719 (2011). https://doi.org/10.1007/s00192-010-1328-5
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DOI: https://doi.org/10.1007/s00192-010-1328-5