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Overactive Bladder Symptoms After Pelvic Organ Prolapse Repair

Johnson, Justine R., MD*; High, Rachel A., DO; Dziadek, Olivia, MD; Ocon, Adriana, BS§; Muir, Tristi W., MD; Xu, Jiaqiong, PhD; Antosh, Danielle D., MD

Female Pelvic Medicine & Reconstructive Surgery: January 23, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/SPV.0000000000000700
Original Article: PDF Only
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Objectives This study aimed to identify the characteristics associated with overactive bladder (OAB) symptoms perioperatively in patients undergoing pelvic organ prolapse (POP) surgery with and without slings and to determine the rate of OAB symptom resolution postoperatively.

Methods This retrospective, single-institution study involved women undergoing prolapse surgery with and without concomitant midurethral sling from 2011 to 2016. A validated questionnaire was used to determine OAB symptoms preoperatively and postoperatively. The primary outcome was rate of resolution in OAB symptoms after POP surgery with and without midurethral sling. Baseline characteristics and surgery type were presented, and univariate and multivariate logistic regression models were applied to evaluate characteristics associated with OAB symptoms at the first postoperative visit.

Results The analysis included 203 patients. Among those with baseline OAB symptoms, 103 (61%) had symptom resolution, whereas 66 (39.1%) reported persistent symptoms. Among 34 patients without baseline OAB symptoms, 6% developed de novo symptoms. Older age was found to be a significant risk factor for persistence of symptoms postoperatively both on univariate (odds ratio, 0.97; 95% confidence interval, 0.94–1; P = 0.038) and multivariate logistic regression (odds ratio, 0.96, 95% confidence interval, 0.92–1; P = 0.049). The rate of medication discontinuation postoperatively was 25%.

Conclusions Approximately 61% of patients undergoing POP surgery had resolution of OAB symptoms postoperatively whether or not an incontinence procedure was performed. Older age was significantly related to persistent OAB symptoms in both univariate (P = 0.038) and multivariate (P = 0.049) models. The rate of de novo OAB symptoms was 6%.

*From the Department of Obstetrics and Gynecology, The Houston Methodist Hospital, Houston;

Department of Female Pelvic Medicine and Reconstructive Surgery, Baylor Scott & White Health, Temple;

Department of Obstetrics and Gynecology, Memorial Hermann Hospital, Houston;

§Texas A&M Health Sciences Center School of Medicine, Bryan;

Division of Urogynecology, Department of Obstetrics and Gynecology, The Houston Methodist Hospital; and

Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX.

Correspondence: Justine R. Johnson, MD, Department of Obstetrics and Gynecology, The Houston Methodist Hospital, 1401 St Joseph Pkwy, SKS1106a, Houston, TX 77002. E-mail: Justine.Rachel.Johnson@gmail.com.

The authors have declared they have no conflicts of interest.

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