Clinical relevance of occult stress urinary incontinence (OSUI) following vaginal prolapse surgery: long-term follow-up

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• 作者：Stefanie Ennemoser (1)
  Mirjam Sch?nfeld (1)
  Vera von Bodungen (1)
  Darius Dian (1)
  Klaus Friese (1)
  Katharina Jundt (1)
  
• 关键词：Long ; term follow ; up ; Occult stress urinary incontinence ; Vaginal prolapse surgery
• 刊名：International Urogynecology Journal
• 出版年：2012
• 出版时间：July 2012
• 年：2012
• 卷：23
• 期：7
• 页码：851-855
• 全文大小：129KB
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• 作者单位：Stefanie Ennemoser (1)
  Mirjam Sch?nfeld (1)
  Vera von Bodungen (1)
  Darius Dian (1)
  Klaus Friese (1)
  Katharina Jundt (1)
  
  1. Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der LMU -Innenstadt, Maistr. 11, 80337, Munich, Germany
  

文摘

Introduction and hypothesis Patients with genital prolapse and occult stress urinary incontinence (OSUI) are typically treated with prolapse surgery and anti-incontinence surgery based on either a one-step approach or a two-step approach. The aim of our study was to determine whether anti-incontinence surgery is necessary based on the occurrence of OSUI in a study cohort with a long follow-up period. Methods Prolapse surgery was performed using a vaginal approach. Preoperatively, a stress test, a pad test and an assessment of the urodynamics were performed with and without prolapse reduction. Over a follow-up period of 2-?years, the patients with preoperative evidence of OSUI underwent urogynaecological examinations, stress tests and pad tests. Results Of 113 patients with preoperative evidence of OSUI, 57 (50.4?%) were followed up for an average of 5.7?years (range 2-) after prolapse surgery. Of 57 patients, 16 (28.1?%) had objective and/or subjective stress urinary incontinence (SUI) during the follow-up period, but only 3 patients (5.3?%) required subsequent tension-free vaginal tape (TVT) surgery. In 17 of 57 patients (29.8?%), prolapse recurred. Conclusions Despite the preoperative evidence of OSUI, the manifestation of SUI rarely occurs, with 28.1?% of patients experiencing SUI over long-term follow-up after vaginal prolapse surgery. Anti-incontinence surgery was necessary in only three cases (5.3?%). These results indicate that with the one-step approach, 54 of 57 patients (94.7?%) would have received prophylactic anti-incontinence surgery unnecessarily. In conclusion, we recommend the two-step approach in the management of vaginal prolapse surgery in patients with OSUI.