Stress incontinence after surgery for pelvic organ prolapse

Tupikina N.V., Kasyan G.R., Gvozdev M.Yu., Barinova M.N., Pushkar' D.Yu.

Purpose: To evaluate the incidence of stress urinary incontinence (SUI) within 6 months follow-up after surgical treatment of pelvic organ prolapse (POP) by vaginal route according to the initial continent function before surgery.

Materials and methods: This study included 82 women who underwent transvaginal surgical repair for POP. We found that 30 patients (group 1) had concomitant SUI and prolapse. The remaining patients without complaint of SUI were divided into group 2 (n=31) had a negative cough test after POP repositioning, and group 3 (n=21) had occult SUI. The results of surgical treatment of POP were evaluated for the presence SUI within 6 months after the operation during office visits and using the UDI-6 questionnaire.

Results: No recurrences of POP were observed. The likelihood of developing SUI after correction of POP in 1 and 3 groups was equivalent for 3 and 6 months of follow-up. However, the frequency of positive cough test was slightly higher in group 1 compared with group 3. Six months later, the percentage of the operated patients because of SUI in both groups was the same. The likelihood of developing SUI after correction of genital prolapse in patients without SUI at baseline reached 16% after six months, and only 1 in 4 patients with cough positive tests was performed surgical correction of SUI.

Conclusion: Treatment tactics for patients with overt and occult SUI can be similar because the likelihood of developing SUI after surgical correction of POP is the same. A three-month follow-up period is ideal for the assessment of continence function in patients with severe SUI, and this is the best time to perform anti-stress surgery. In cases with no severe SUI or mixed SUI, the follow-up should be continued for up to 6 months or more.

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