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Published on: August 28, 2020
Mixed incontinence and cystocele: postoperative urge symptoms are not predicted by preoperative urodynamics
Christopher E Wolter1, Melissa R Kaufman, John W Duffy
1Department of Urologic Surgery, Vanderbilt University Medical Center, A-1302 Medical Center North, Nashville, TN 37232-2765, USA. wolter.christopher@mayo.edu
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.
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