TY - JOUR
T1 - Mixed incontinence and cystocele
T2 - Postoperative urge symptoms are not predicted by preoperative urodynamics
AU - Wolter, Christopher E.
AU - Kaufman, Melissa R.
AU - Duffy, John W.
AU - Scarpero, Harriette M.
AU - Dmochowski, Roger R.
PY - 2011/3
Y1 - 2011/3
N2 - Introduction and hypothesis: Pelvic organ prolapse (POP) frequently presents with urinary incontinence, either urge (UUI), stress (SUI), or mixed (MUI). We sought to determine the effect of high-grade prolapse repair on MUI. Methods: A retrospective review was performed for 111 patients with anterior POP repair and sling over 4 years. Results: Sixty patients (54%) presented symptomatically with MUI, 25% with SUI, and 9% with UUI, 12% asymptomatic. Occult SUI was found in 21% (UUI plus asymptomatic). Success was seen for SUI in 92% and for POP in 89%. Urge symptoms were present in 63% pre-op and 30% post-op. MUI patients were significantly more likely to experience post-op urgency (p = 0.033). Detrusor overactivity (DO) was seen in 22 MUI patients, but was not predictive of post-op urgency (p = 0.91). Conclusions: Cystocele patients with MUI are at significant risk for postoperative urge symptoms regardless of DO, and counseling regarding persistent urgency is imperative.
AB - Introduction and hypothesis: Pelvic organ prolapse (POP) frequently presents with urinary incontinence, either urge (UUI), stress (SUI), or mixed (MUI). We sought to determine the effect of high-grade prolapse repair on MUI. Methods: A retrospective review was performed for 111 patients with anterior POP repair and sling over 4 years. Results: Sixty patients (54%) presented symptomatically with MUI, 25% with SUI, and 9% with UUI, 12% asymptomatic. Occult SUI was found in 21% (UUI plus asymptomatic). Success was seen for SUI in 92% and for POP in 89%. Urge symptoms were present in 63% pre-op and 30% post-op. MUI patients were significantly more likely to experience post-op urgency (p = 0.033). Detrusor overactivity (DO) was seen in 22 MUI patients, but was not predictive of post-op urgency (p = 0.91). Conclusions: Cystocele patients with MUI are at significant risk for postoperative urge symptoms regardless of DO, and counseling regarding persistent urgency is imperative.
KW - Cystocele
KW - Mixed incontinence
KW - Urgency
KW - Urodynamics
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U2 - 10.1007/s00192-010-1261-7
DO - 10.1007/s00192-010-1261-7
M3 - Article
C2 - 20842495
AN - SCOPUS:79951608124
SN - 0937-3462
VL - 22
SP - 321
EP - 325
JO - International Urogynecology Journal
JF - International Urogynecology Journal
IS - 3
ER -