Frequency urgency syndrome following urinary bladder suspension

Bladder suspension for urinary incontinence secondary to bladder neck hypermobility is highly successful. Of those who fail, however, a subset will develop new onset or markedly worsened irritative voiding symptoms. A series of such patients were identified to study the associated urodynamic abnormalities of this symptom complex. The charts of female patients presenting for incontinence from 1992-94 were reviewed. Forty-six patients with a mean age of 59.4 (range 28-79) fulfilled the inclusion criteria of developing new onset or markedly worsened post-operative frequency, urgency and urge incontinence within two years of undergoing bladder suspension. All had been evaluated with thorough history, physical examination, and urodynamic testing. Seventeen patients were found to have recurrent hypermobility. Eighteen had a diagnosis of intrinsic sphincter deficiency (ISD), including six that also had another diagnosis. Four patients were diagnosed with detrusor overactivity and seven with other miscellaneous diagnoses. Patients presenting with this symptom complex should be evaluated so that treatment can be tailored appropriately.