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Related Experiment Videos

Reevaluating occult incontinence.

Alexandra L Haessler1, Lawrence L Lin, Mat H Ho

  • 1Urogynecology & Pelvic Reconstructive Surgery, Harbor-UCLA Medical Center, Los Angeles, California 90509, USA. ahaessler@obgyn.humc.edu

Current Opinion in Obstetrics & Gynecology
|September 6, 2005
PubMed
Summary

Occult incontinence may increase the risk of postoperative stress urinary incontinence (POSUI) after pelvic organ prolapse repair. Prophylactic anti-incontinence procedures show potential benefit in reducing POSUI incidence.

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Area of Science:

  • Urology
  • Gynecology
  • Pelvic Health

Background:

  • Occult incontinence lacks extensive literature and is controversially linked to increased postoperative stress urinary incontinence (POSUI) risk after pelvic organ prolapse (POP) repair.
  • Historically, prophylactic incontinence procedures have been debated for patients with occult incontinence undergoing POP repair.

Purpose of the Study:

  • To explore evidence on occult incontinence and its association with POSUI risk.
  • To review data from intervention trials for occult incontinence.
  • To address remaining questions regarding occult incontinence management in POP repair.

Main Methods:

  • Literature review focusing on occult incontinence and POSUI.
  • Analysis of existing data on screening tests and anti-incontinence procedures.

Related Experiment Videos

  • Evaluation of evidence regarding the predictive value of stress tests.

    • Main Results:

    • Limited evidence indicates 11-22% of continent POP patients develop POSUI; occult incontinence patients face substantially higher risk.
    • Anti-incontinence procedures in occult incontinence patients may reduce POSUI incidence to 0-15%, suggesting screening benefits.
    • Study designs are often small, and results vary on the reliability of negative stress tests for ruling out POSUI risk.

    Conclusions:

    • Minimal English literature suggests occult incontinence increases POSUI risk after POP repair.
    • Systematic study of outcomes in occult incontinence patients undergoing POP repair is needed.
    • Current evidence is insufficient to reliably counsel patients on POSUI prevention or unnecessary procedures.