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

Lo, Tsia‐Shu; Karim, Nazura bt; Nawawi, Enie Akhtar; Wu, Pei‐Ying; Nusee, Zalina

doi:10.1007/s00192-015-2685-x

Cited by 53 publications

(54 citation statements)

References 26 publications

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“…Women aged 50 years or older had twice the risk of OSUI compared to those younger than 50 years (P<0.005). This is comparable to Lo et al who found that women older than 66 years were 2.86 times at greater risk of developing de novo SUI postoperatively (19). In addition, age is an important confounding factor in relation to concomitant medical illnesses which may aggravate urinary incontinence.…”

Section: Discussionsupporting

confidence: 76%

“…Reena et al found postmenopausal women had a statistically significant risk of developing OSUI (17). This is supported by Lo et al who showed postmenopausal status is independent predictors for de novo SUI following extensive POP repair (19). In addition, estrogen replacement is thought to alleviate incontinence by facilitating proliferation and maturation of urethral mucosa in postmenopausal women (24).…”

Section: Discussionmentioning

confidence: 90%

“…Prolapse repositioning with rectal swabs was superior in detecting OSUI as it significantly lowered the midurethral closure pressure and causes a shorter functional urethral length compared to other techniques. This is because low MUCP and functional urethral length during preoperative urodynamic evaluation are significant predictors for occult SUI (19). In contrast, another consensus showed detection rate was lower with pessary than with speculum prolapse reduction (20).…”

Section: Discussionmentioning

confidence: 99%

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The Prevalence and Risk Factors of Occult Stress Urinary Incontinence in Women Undergoing Genitourinary Prolapse Surgery

Latip¹

2016

JSA

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De novo stress urinary incontinence (SUI) may occur in up to 80% of clinically continent women following genitourinary prolapse surgery. This had resulted in an increase in the rate of concurrent continence surgery during prolapse repair from 38% in 2001 to 47% in 2009 in the United States. To date, there is no local data available to estimate the prevalence of occult SUI (OSUI) among Malaysian women awaiting surgery. Therefore, this study was conducted to elicit the prevalence of occult SUI and its associated risks factors in patients awaiting prolapse surgery. We retrospectively studied the records of 296 consecutive women with significant pelvic organ prolapse awaiting reconstructive repair. All patients attended the Urogynaecology Unit in Hospital Kuala Lumpur Malaysia between October 2007 and September 2011. They had undergone standardized interviews, clinical examinations and urodynamic studies. During the urodynamic testings, all prolapses were reduced using ring pessaries to elicit OSUI. Primary outcome was the prevalence of OSUI with prolapse reduction to predict possibility of developing de novo SUI following prolapse surgery. Secondary outcome was the assessment of potential risk factors for OSUI. Among the 296 women studied, 121 (40.9%) were found to have OSUI. The risk factors associated with OSUI included age, BMI, numbers of SVD, recurrent UTI, reduction of urinary flow symptoms and grade 2 to 4 central compartment prolapses. We concluded that preoperative urodynamic testing with reduction of prolapse is useful to identify women with OSUI. This is important for preoperative counselling as well as planning for one step approach of prophylactic concomitant anti-incontinence procedures during prolapse surgery in order to avoid postoperative de novo SUI.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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The Prevalence and Risk Factors of Occult Stress Urinary Incontinence in Women Undergoing Genitourinary Prolapse Surgery

Latip¹

2016

JSA

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“…However, varieties of LUTS including, de novo overactive bladder89, voiding dysfunction and de novo urinary stress incontinence10 may occur after mesh implantation surgery for POP. It would be difficult to differentiate if the LUTS were brought about by a transient physiologic phenomenon secondary to the surgical procedure or a result of a worrisome reaction to the mesh.…”

mentioning

confidence: 99%

The immunohistochemical and urodynamic evaluation towards the collagen-coated and non-coated polypropylene meshes implanted in the pelvic wall of the rats

Lin

Yusoff

et al. 2016

Sci Rep

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Our aim is to study the inflammatory response towards the collagen-coated and non-coated polypropylene meshes in rats and the urodynamic investigation post-operatively. Forty-two female Sprague Dawley were divided into 7 groups of 6 rats; Control, Day 7 and 30 for Sham, Avaulta Plus (MPC), Perigee (MP). UDS were taken at days 7 and 30. Mesh with the vagina and bladder wall was removed and sent for immunohistochemical examination. Results showed intense inflammatory reaction on day 7 in the study groups which decreased on day 30. IL-1, TNF-α, MMP-2 and CD31 were observed to decrease from day 7 to day 30. NGF was almost normal on day 30 in all groups. UDS showed no difference in voiding pressure. Both Study and Sham groups had shorter voiding interval (VI) on day 7 but significantly lower in MPC. VI had significantly increased on day 30 in all groups. Voided volume was significantly lower in the mesh groups even when an increase was seen on day 30. In conclusion, the higher levels of IL-1, TNF-α and MMP-2 in collagen-coated polypropylene mesh imply greater inflammation than the non-coated polypropylene mesh. Mesh implantation can lead to shorter voiding interval and smaller bladder capacity.

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“…One patient developed dSUI despite the standard urodynamics with prolapse reduction using ring pessary. Lo et al noted a prevalence of dSUI on extensive pelvic reconstructive surgery of 11.1% . Patients aged > 66 years, with diabetes mellitus, and low mean urethral closure pressure and functional urethral length during preoperative urodynamic evaluation, have higher risk of developing dSUI …”

Section: Discussionmentioning

confidence: 99%

Transvaginal management of severe pelvic organ prolapse in nulliparous women

Jaili

Uy-Patrimonio

et al. 2017

J of Obstet and Gynaecol

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

Abstract: 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.

Cited by 53 publications

References 26 publications

The Prevalence and Risk Factors of Occult Stress Urinary Incontinence in Women Undergoing Genitourinary Prolapse Surgery

The Prevalence and Risk Factors of Occult Stress Urinary Incontinence in Women Undergoing Genitourinary Prolapse Surgery

The immunohistochemical and urodynamic evaluation towards the collagen-coated and non-coated polypropylene meshes implanted in the pelvic wall of the rats

Transvaginal management of severe pelvic organ prolapse in nulliparous women

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