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Int Urogynecol J. 2013 Jan;24(1):47-54. doi: 10.1007/s00192-012-1844-6. Epub 2012 Jun 22.

Which women develop urgency or urgency urinary incontinence following midurethral slings?

Author information

1
Department of Urogynaecology, Mercy Hospital for Women, 163 Studley Road, Heidelberg, VIC, 3084, Australia. joseph.lee@southernhealth.org.au

Abstract

INTRODUCTION AND HYPOTHESIS:

De novo urgency has a negative impact on women after midurethral sling (MUS). We aimed to identify risk factors for de novo urgency (dU) and urgency urinary incontinence (dUUI) following MUS, using multivariate analysis.

METHODS:

We investigated 358 consecutive women with only stress urinary incontinence (SUI) [or urodynamic stress incontinence (USI)] and 598 women with both SUI (or USI) and urgency (but not UUI) who underwent MUS with a mean follow-up of 50 months. Women who developed dU or dUUI at long-term follow-up were compared to those who did not.

RESULTS:

dU occurred in 27.7 % (99/358) and dUUI occurred in 13.7 % (82/598) of women at long-term follow-up after midurethral sling. Intrinsic sphincter deficiency {odds ratio (OR) dU 3.94 [95 % confidence interval (CI) 1.50-10.38]; OR dUUI 2.5 (1.31-4.80)}, previous stress incontinence surgery [sling: OR dU 3.69 (1.45-9.37); colposuspension: OR dUUI 2.5 (1.23-5.07)], previous prolapse surgery [OR dU 2.45 (1.18-5.10)], preexisting detrusor overactivity [OR dU 1.99 (1.15-3.48); OR dUUI 1.85 (1.31-2.60)] increased the risk, whereas performing concomitant apical prolapse surgery [OR dU 0.5 (0.41-0.81); OR dUUI 0.29 (0.087-0.97)] significantly decreased the risk. Women are more likely to not recommend surgery when they experienced dU (18.2 vs 0.8 %, pā€‰<ā€‰0.0001) or dUUI (20.7 vs 2.1 %, pā€‰<ā€‰0.0001).

CONCLUSIONS:

Urodynamic parameters, history of prior incontinence or prolapse surgery and concomitant apical prolapse operation were important predictors of dU or dUUI following MUS.

PMID:
22722646
DOI:
10.1007/s00192-012-1844-6
[Indexed for MEDLINE]

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