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Urodynamic Prediction of Occult Stress Urinary Incontinence Before Vaginal Surgery for Advanced Pelvic Organ Prolapse: Evaluation of Postoperative Outcomes

Duecy, Erin E. MD; Pulvino, James Q. MD; McNanley, Anna R. MD; Buchsbaum, Gunhilde M. MD

Female Pelvic Medicine & Reconstructive Surgery: July/August 2010 - Volume 16 - Issue 4 - pp 215-217
doi: 10.1097/SPV.0b013e3181e4f11e
Original Articles
Journal Club

Objectives: To evaluate the use of urodynamics for assessment of occult stress urinary incontinence (SUI) in women undergoing vaginal surgery for advanced pelvic organ prolapse (POP).

Methods: Retrospective chart review of women who underwent vaginal surgery for advanced POP at the University of Rochester Medical Center.

Results: The study sample was composed of 41 women (mean age: 65.6 years; range: 42-88 years). Prolapse was stage 3 or 4 in 40 (97.6%) women. Urodynamics identified 17 (41.5%) women with occult SUI. Postoperatively, 3 (7.3%) women reported urinary incontinence: 1 with stress and 2 with urge-related symptoms. The woman with postoperative SUI had been diagnosed with occult SUI, but declined continence repair. None of the women without occult SUI on urodynamics reported postoperative SUI.

Conclusions: Urodynamic evaluation prior to vaginal surgery for advanced POP can identify women at risk for SUI, who may benefit from concomitant continence repair.

Urodynamic evaluation prior to vaginal surgery for advanced pelvic organ prolapse can identify women at risk for stress urinary incontinence, who may benefit from concomitant continence repair.

From the Departments of *Obstetrics and Gynecology, and †Urology, University of Rochester Medical Center, Rochester, NY.

Reprints: Anna R. McNanley, MD, Department of Obstetrics and Gynecology, Box 668, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642. E-mail: anna_mcnanley@urmc.rochester.edu.

No reprints will be available.

The authors declare no conflicts of interest.

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