INTRODUCTIONPelvic organ prolapse (POP) and stress urinary incontinence (SUI) are two common health-related conditions. They affect up to 50% women worldwide individually.1 Stress urinary incontinence is a condition of involuntary loss of urine on effort, physical exertion, sneezing, or coughing that is often bothersome to the patient and frequently affects the quality of life. It is estimated to affect 15.7% of adult women.2 Many times this urinary incontinence is detected following corrective prolapse surgery. If a woman with pelvic organ prolapse leaks only when the prolapse is reduced, it is called occult stress urinary incontinence (OSUI).
3The prevalence of OSUI in women with severe genitourinary prolapse varies from 27-68% in literature. 4,5 If any previously continent woman develops urinary incontinence after vaginal hysterectomy and pelvic floor repair, it is a frustrating condition for both the patient and the physician.So it is important to counsel symptomatically continent women with POP for developing post-operative SUI (POSUI). Bump RC et al and Fianu et al have showed that POP, may mask SUI. 6,7 The colpopexy and urinary reduction efforts(CARE) study, the largest randomized trial, showed that 45% of women with POP developed POSUI subjectively and objectively as well. [8][9][10] In a study ABSTRACT Background: Pelvic organ prolapse and stress urinary incontinence are two common health-related conditions. If a woman with pelvic organ prolapse leaks only when the prolapse is reduced, it is called occult stress urinary incontinence (OSUI). The prevalence of OSUI in women with severe genitourinary prolapse varies from 27-68% in literature. In this study we want to find out the relationship between OSUI and stress urinary incontinence (SUI) following corrective surgery.The objectives of the study are to determine the number of women with urinary leak following reduction of prolapse before surgery; to determine the number women with occult stress urinary incontinence developing stress urinary incontinence following surgery and to determine the risk of developing stress urinary incontinence after vaginal hysterectomy and pelvic floor repair in these women. Methods: This is a longitudinal observational study. All women with pelvic organ prolapse (POP) of grade II or higher requiring corrective surgery were initially evaluated for OSUI using vaginal pack and followed up post operatively at 6 weeks and 12 weeks using QUID to look for post-operative stress urinary incontinence (POSUI).
Results:The overall incidence of OSUI in our study was 7.5%. OSUI was significantly associated with factors like older age, higher BMI, high parity, short inter pregnancy interval and higher grade of prolapse and not significantly associated with factors like place of delivery, delivery events and mode of delivery.
Conclusions:It is important to test all women with POP for OSUI and patients with OSUI need long term follow up to detect POSUI