Frequency urgency syndrome following urinary bladder suspension

Area of Science:

• Urology
• Female Pelvic Medicine
• Urogynecology

Background:

• Bladder suspension surgery is effective for urinary incontinence due to bladder neck hypermobility.
• A subset of patients experience new or worsened irritative voiding symptoms post-surgery.

Purpose of the Study:

• To investigate the urodynamic abnormalities associated with new-onset or worsened irritative voiding symptoms after bladder suspension.
• To identify underlying causes in patients experiencing treatment failure and symptom exacerbation.

Main Methods:

• Retrospective chart review of female patients undergoing bladder suspension between 1992-1994.
• Inclusion criteria: new/worsened post-operative frequency, urgency, or urge incontinence within two years.
• Evaluation included history, physical examination, and urodynamic testing.

Main Results:

• Forty-six patients met inclusion criteria.
• Diagnoses included recurrent hypermobility (17), intrinsic sphincter deficiency (ISD) (18), detrusor overactivity (4), and miscellaneous (7).
• Six patients with ISD also had another diagnosis.

Conclusions:

• Post-bladder suspension irritative voiding symptoms warrant thorough urodynamic evaluation.
• Identifying specific urodynamic abnormalities is crucial for appropriate patient management.
• Tailored treatment based on urodynamic findings can optimize outcomes for these complex cases.