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01-01-2022 | Overactive Bladder | Original Article

Pelvic organ prolapse surgery and overactive bladder symptoms—a population-based cohort (FINPOP)

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

Published in: International Urogynecology Journal | Issue 1/2022

Abstract

Introduction and hypothesis

It is unclear how compartment of pelvic organ prolapse (POP) impacts overactive bladder (OAB) symptom severity or improvement after POP surgery. We hypothesized that anterior and apical prolapse are more strongly associated with OAB symptoms than posterior compartment prolapse.

Methods

A total of 2933 POP surgeries from a prospective population-based cohort were divided into two groups: (1) anterior and/or apical compartment surgery (± posterior repair), N = 2091; (2) posterior repair only, N = 478. Urinary frequency and urgency urinary incontinence (UUI) were evaluated using PFDI-20 (bothersome symptom: score 3–4) at baseline, 6, and 24 months. Association between degree of POP in specific compartments and symptoms at baseline was estimated with generalized linear models and between compartment of surgery and symptom improvement with generalized estimating equations.

Results

At least one bothersome symptom was reported by 40% at baseline, 14% at 6, and 19% at 24 months. At baseline, urinary frequency was associated with degree of anterior and apical and UUI with anterior compartment prolapse. Women undergoing surgery for anterior/apical compartment started with worse symptoms and experienced greater improvement than women undergoing posterior compartment surgery. Bothersome frequency resolved in 82% after anterior/apical and in 63% after posterior compartment surgery. Bothersome UUI resolved in 75% after anterior/apical and in 61% after posterior compartment surgery. After surgery, symptom severity was comparable between groups. Bothersome de novo symptoms occurred in 1–3%.

Conclusions

OAB symptoms are more strongly related to anterior and apical than to posterior compartment prolapse, but improvement is seen after surgery for any vaginal compartment.

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Title: Pelvic organ prolapse surgery and overactive bladder symptoms—a population-based cohort (FINPOP)
Authors: Päivi K. Karjalainen
Anna-Maija Tolppanen
Nina K. Mattsson
Olga A.E. Wihersaari
Jyrki T. Jalkanen
Kari Nieminen
Publication date: 01-01-2022
Publisher: Springer International Publishing
Keywords: Overactive Bladder
Urinary Incontinence
Urinary Incontinence
Published in: International Urogynecology Journal / Issue 1/2022
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-021-04920-w

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Pelvic organ prolapse surgery and overactive bladder symptoms—a population-based cohort (FINPOP)

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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