Related Experiment Video
Updated: Jul 12, 2026
03:49
Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse (POP) Quantification System
Published on: September 20, 2018
Is occult stress urinary incontinence truly "occult"?
Xingqi Wang1, Ling Li1, Zhenhua Gao1
1Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
Gynecology and Pelvic Medicine
|July 10, 2026
Summary
Occult stress urinary incontinence (OSUI) after pelvic organ prolapse (POP) repair is not truly hidden. It arises from altered biomechanics post-surgery, not obstruction, highlighting the need for physiological reconstruction.
Area of Science:
- Urogynecology
- Female Pelvic Medicine
- Reconstructive Surgery
Background:
- Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) often coexist.
- Occult stress urinary incontinence (OSUI) can manifest post-POP repair, traditionally attributed to urethral obstruction.
- This leads to debate on concurrent anti-incontinence procedures during POP surgery.
Purpose of the Study:
- To challenge the conventional understanding of OSUI.
- To propose that OSUI results from biomechanical changes post-apical suspension surgery.
- To advocate for physiological reconstruction over mere anatomical correction in POP repair.
Main Methods:
- Review of surgical approaches for POP repair (posterior, anterior, lateral, mesh-based suspensions).
- Analysis of biomechanical factors influencing urinary control post-surgery.
- Evaluation of underlying support deficits contributing to OSUI.
Main Results:
- OSUI is argued to be a consequence of altered biomechanics, not true occult obstruction.
- Apical suspension surgery may fail to restore physiological function or support integrity.
- Uncorrected deficits like levator ani fissure enlargement and inadequate vaginal support contribute to postoperative SUI.
Conclusions:
- OSUI is not truly occult but results from surgical biomechanical alterations.
- Apical suspension alone may not prevent OSUI due to unaddressed functional defects.
- Physiological reconstruction is proposed as a strategy to reduce OSUI risk.
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