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Postoperative Urinary Incontinence in Diabetic Patients Undergoing Pelvic Reconstructive Surgery.

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Diabetes increases the risk of urinary incontinence after pelvic reconstructive surgery. Patients undergoing prolapse and anti-incontinence surgery experienced higher rates of new-onset urgency urinary incontinence (UUI) compared to prolapse surgery alone.

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Area of Science:

  • Urology
  • Gynecology
  • Endocrinology

Background:

  • Diabetes mellitus is a known risk factor for urinary incontinence.
  • The impact of diabetes on postoperative urinary incontinence after pelvic reconstructive surgery is not well understood.

Purpose of the Study:

  • To compare the incidence of postoperative stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence.
  • To evaluate outcomes in patients with diabetes undergoing pelvic organ prolapse (POP) surgery with or without concurrent anti-incontinence procedures.

Main Methods:

  • Secondary analysis of a multicenter retrospective cohort study.
  • Involved 10 medical centers and women with diabetes undergoing POP and/or anti-incontinence surgery.
  • Compared postoperative UI rates between women who had surgery for POP and incontinence versus POP only.

Main Results:

  • De novo UUI was significantly higher in the POP and SUI surgery group (26.4%) compared to POP surgery alone (14.1%).
  • Persistent SUI (21% vs 4.9%) and mixed UI (15.9% vs 2.7%) were higher in the POP surgery alone group.
  • No difference in hemoglobin A1C levels was observed between patients with and without postoperative UI.

Conclusions:

  • Postoperative de novo UUI is common in diabetic patients after pelvic reconstructive surgery.
  • The incidence of de novo UUI is significantly higher when incontinence surgery is combined with prolapse repair.