Urge Incontinence After Pelvic Organ Prolapse Surgery: A Secondary Analysis.

Area of Science:

• Urogynecology
• Female Pelvic Medicine

Background:

• Pelvic organ prolapse (POP) frequently co-occurs with overactive bladder and urgency urinary incontinence (UUI), affecting 6x more women.
• Evaluating the impact of POP surgical repair on UUI is crucial for patient counseling.

Purpose of the Study:

• To assess the effect of apical and/or anterior wall POP repair on UUI symptoms in women.
• To analyze changes in overall urinary function post-POP surgery.

Main Methods:

• Secondary analysis of data from the SUPeR, OPTIMAL, and OPUS trials.
• Urgency urinary incontinence (UUI) symptoms evaluated using the Pelvic Floor Distress Inventory (PFDI).
• Urinary function assessed via Urogenital Distress Inventory-6 (UDI-6) and Urinary Impact Questionnaire-7 (UIQ-7) subscores.

Main Results:

• Seven hundred thirty-five women analyzed; 82.3% had native tissue repair.
• Postoperative improvement in UUI and bladder emptying observed across all surgical approaches.
• Greatest UUI symptom improvement seen with combined uterosacral/sacrospinous ligament suspension, anterior repair, and midurethral sling (MUS).

Conclusions:

• Surgical repair of pelvic organ prolapse (POP) effectively improves urgency urinary incontinence (UUI).
• Native tissue repair combined with anterior repair and midurethral sling (MUS) demonstrated the most significant UUI symptom reduction.