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International Urogynecology Journal

Published in:

01-09-2015 | Original Article

Predictors for de novo stress urinary incontinence following extensive pelvic reconstructive surgery

Authors: Tsia-Shu Lo, Nazura bt Karim, Enie Akhtar Nawawi, Pei-Ying Wu, Zalina Nusee

Published in: International Urogynecology Journal | Issue 9/2015

Abstract

Introduction and hypothesis

The aim of this study was to look for 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 included in 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 anti-incontinent surgery.

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Title: Predictors for de novo stress urinary incontinence following extensive pelvic reconstructive surgery
Authors: Tsia-Shu Lo
Nazura bt Karim
Enie Akhtar Nawawi
Pei-Ying Wu
Zalina Nusee
Publication date: 01-09-2015
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 9/2015
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-015-2685-x

At a glance: The STEP trials

Springer Medicine

Predictors for de novo stress urinary incontinence following extensive pelvic reconstructive surgery

Abstract

Introduction and hypothesis

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Materials and methods

Results

Conclusions

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