The role of preoperative urodynamic testing in stress-continent women undergoing sacrocolpopexy: the Colpopexy and Urinary Reduction Efforts (CARE) randomized surgical trial

Visco, Anthony G.; Brubaker, Linda; Nygaard, Ingrid; Richter, Holly E.; Cundiff, Geoffrey W.; Fine, Paul; Zyczynski, Halina M.; Brown, Morton B.; Weber, Anne M.

doi:10.1007/s00192-007-0498-2

Cited by 195 publications

(151 citation statements)

References 22 publications

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“…Our prevalence rates of OSUI was higher compared to those found in CARE trial (40.9% vs. 19%) (6). This could be explained by the difference in repositioning method used.…”

Section: Discussioncontrasting

confidence: 76%

“…This could be explained by the difference in repositioning method used. Despite various methods of prolapse reduction used in the CARE trial, the detection rate of OSUI was lower compared to our study which only use ring pessary as the reduction method (6). Other authors used rectal swabs, Gel horn pessary or Grave's speculum for prolapse reduction (17).…”

Section: Discussioncontrasting

confidence: 73%

“…The mechanism by which severe prolapse particularly large cystocele may mask SUI in an apparently continent women is via the cushioning effect of the cystocele which dissipated the effect of the abdominal pressure on the bladder outlet. In addition, the prolapsed bladder on the urethra may also cause urethral kinking causing an increase in the intra-urethral pressure (6). As for posterior wall defect, the prolapsed bowel may compress and/or support the bladder neck, providing continence during straining.…”

Section: Introductionmentioning

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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“…Our prevalence rates of OSUI was higher compared to those found in CARE trial (40.9% vs. 19%) (6). This could be explained by the difference in repositioning method used.…”

Section: Discussioncontrasting

confidence: 76%

Section: Discussioncontrasting

confidence: 73%

Section: Introductionmentioning

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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“…Speculum prolapse reduction was associated with the highest (30 %) and pessary with the lowest (6 %) SUI detection rates. The study also showed that preoperative SUI with prolapse reduction during urodynamics was associated with high risk for SUI at 3 months after surgery [25].…”

Section: Pelvic Organ Prolapsementioning

confidence: 65%

Role of Urodynamics in the Evaluation of Elderly Voiding Dysfunction

Mahdy

Ghoniem

2014

Curr Bladder Dysfunct Rep

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Voiding dysfunction is a common condition in the elderly that can affect both men and women. Due to the ageassociated changes in the lower urinary tract, voiding dysfunction in the elderly is usually complex and multifactorial, necessitating more objective testing sometimes. In this chapter, we will focus on the role of urodynamics in the setting of voiding dysfunction in the elderly. The term voiding dysfunction will be used to refer both to storage and obstructive lower urinary tract symptoms.

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“…In the CARE study, patients with prolapse but without complaints of incontinence underwent a sacrocolpopexy and were randomized to a Burch procedure or not. They underwent preoperative urodynamic prolapse reduction stress testing by a variety of methods [37]. In the OPUS trial, patients with prolapse but without complaints of incontinence underwent a vaginal prolapse repair and were randomized to TVT retropubic midurethral sling or not [35••].…”

Section: Urodynamics In the Evaluation Of Prolapsementioning

confidence: 99%

Role of Urodynamics in the Evaluation of Urinary Incontinence and Prolapse

Nager

2013

Curr Obstet Gynecol Rep

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Urodynamics are functional tests of the bladder that are commonly requested for the evaluation of urinary incontinence and prolapse. As a diagnostic test that also can provide prognostic information, urodynamics should be requested when there is a specific question that needs to be answered. This chapter will review the literature that pertains to the common reasons for requesting urodynamics before stress urinary incontinence surgery and review recent randomized trials on urodynamic testing before stress incontinence surgery. In addition, the chapter will compare the predictive ability of urodynamic prolapse reduction stress testing with office-based prolapse reduction stress testing for detecting postoperative stress urinary incontinence in women without symptoms of stress urinary incontinence undergoing prolapse surgery.

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The role of preoperative urodynamic testing in stress-continent women undergoing sacrocolpopexy: the Colpopexy and Urinary Reduction Efforts (CARE) randomized surgical trial

Cited by 195 publications

References 22 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

Role of Urodynamics in the Evaluation of Elderly Voiding Dysfunction

Role of Urodynamics in the Evaluation of Urinary Incontinence and Prolapse

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