Changes in Urgency Urinary Incontinence Symptoms After Stress Urinary Incontinence Surgery in Women

Area of Science:

• Urology
• Gynecology
• Female Pelvic Medicine

Background:

• Stress urinary incontinence (SUI) and mixed urinary incontinence (MUI) are common conditions requiring surgical intervention.
• SUI surgery can impact pre-existing urgency urinary incontinence (UUI) symptoms, potentially improving or worsening them, or causing de novo UUI.

Purpose of the Study:

• To assess the prevalence of improvement and deterioration in urgency urinary incontinence (UUI) following primary surgery for stress or mixed urinary incontinence.
• To compare outcomes between tension-free vaginal tape (TVT) and periurethral injection therapy (PIT).

Main Methods:

• A registry-based study utilizing data from the Norwegian Female Incontinence Registry.
• Comparison of pre- and 6-12 months postoperative UUI scores for 2710 women undergoing TVT and 305 women undergoing PIT (Bulkamid).
• Analysis related to age and body mass index (BMI).

Main Results:

• Postoperative improvement in UUI was reported by 79% after TVT versus 54% after PIT.
• De novo UUI occurred in 6% after TVT and 20% after PIT.
• Worsening of UUI symptoms was observed in 4.2% after TVT and 11.8% after PIT.

Conclusions:

• Surgery for SUI/MUI can significantly improve UUI symptoms in up to 79% of patients.
• Women with preoperative pure SUI have a higher risk of developing de novo UUI after PIT (20%) compared to TVT (6%).
• Preoperative counseling is crucial, especially for women without pre-existing UUI, to manage expectations regarding potential UUI changes post-surgery.