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

Tsia-Shu, Lp and Karim, Nazura and Nawawi, Erni Akhtar and Nusee, Zalina (2015) Predictors for de novo stress urinary incontinence following extensive pelvic reconstructive surgery. International Urogynaecology Journal, 26 (9). pp. 1313-1319. ISSN 0937-3462 E-ISSN 1433-3023

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Abstract

Introduction and hypothesis The aim of this study was to lookfor 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 includedin 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 antiincontinent surgery.

Item Type:	Article (Journal)
Additional Information:	5527/44019
Uncontrolled Keywords:	de novo SUI MUCP FUL
Subjects:	R Medicine > RG Gynecology and obstetrics
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Obstetric & Gynecology
Depositing User:	salina mohammad
Date Deposited:	27 Jul 2015 10:11
Last Modified:	15 Nov 2017 08:55
URI:	http://irep.iium.edu.my/id/eprint/44019

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