International Urogynecology Journal

, Volume 24, Issue 3, pp 407–411

Predictor of de novo stress urinary incontinence following TVM procedure: a further analysis of preoperative voiding function

  • Masato Kuribayashi
  • Yasuhide Kitagawa
  • Kazutaka Narimoto
  • Satoko Urata
  • Shohei Kawaguchi
  • Mikio Namiki
Original Article


Introduction and hypothesis

The purpose of this study was to evaluate the predictors of de novo stress urinary incontinence (SUI) in patients undergoing a tension-free vaginal mesh procedure (TVM) for pelvic organ prolapse (POP).


Sixty-five patients without SUI were assessed with regard to voiding function by a pressure flow study and clinical characteristics.


The mean age of the patients was 67 ± 8.3. Of the 65 patients, 41 (63 %) maintained urinary continence postoperatively and 24 (37 %) showed de novo SUI. In univariate analysis, the de novo SUI group included a significantly higher proportion of patients with preoperative obstruction, defined as moderate or greater obstruction according to the Blaivas nomogram (29 vs 7 %, P = 0.035). In multivariate analysis, urethral obstruction was an independent predictor of de novo SUI with an odds ratio of 12.616 (95 % confidence interval 1.580–268.731).


Preoperative evaluation of urethral obstruction will contribute to prediction of de novo SUI combined with a conventional diagnosis of occult SUI.


De novo SUI Pelvic organ prolapse Pressure flow study TVM procedure 


  1. 1.
    Altman D, Väyrynen T, Engh ME et al (2011) Anterior colporrhaphy versus transvaginal mesh for pelvic-organ prolapse. N Engl J Med 364(19):1826–1836PubMedCrossRefGoogle Scholar
  2. 2.
    Caquant F, Collinet P, Debodinance P et al (2008) Safety of Trans Vaginal Mesh procedure: retrospective study of 684 patients. J Obstet Gynaecol Res 34(4):449–456PubMedCrossRefGoogle Scholar
  3. 3.
    Vaiyapuri GR, Han HC, Lee LC et al (2011) Use of the Gynecare Prolift® system in surgery for pelvic organ prolapse: 1-year outcome. Int Urogynecol J 22(7):869–877PubMedCrossRefGoogle Scholar
  4. 4.
    Latini JM, Kreder KJ Jr (2005) Associated pelvic organ prolapse in women with stress urinary incontinence: when to operate? Curr Opin Urol 15(6):380–385PubMedCrossRefGoogle Scholar
  5. 5.
    Bai SW, Jeon MJ, Kim J et al (2002) Relationship between stress urinary incontinence and pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 13:256–260PubMedCrossRefGoogle Scholar
  6. 6.
    Stanton SL, Hilton P, Norton C et al (1982) Clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy for prolapse with and without incontinence. Br J Obstet Gynaecol 89:459–463PubMedCrossRefGoogle Scholar
  7. 7.
    Borstad E, Rud T (1989) The risk of developing urinary stress-incontinence after vaginal repair in continent women: a clinical and urodynamic follow-up study. Acta Obstet Gynecol Scand 68:545–549PubMedGoogle Scholar
  8. 8.
    Colombo M, Maggioni A, Zanetta G et al (1996) Prevention of postoperative urinary stress incontinence after surgery for genitourinary prolapse. Obstet Gynecol 87:266–271PubMedCrossRefGoogle Scholar
  9. 9.
    Kleeman S, Vassallo B, Segal J et al (2006) The ability of history and a negative cough stress test to detect occult stress incontinence in patients undergoing surgical repair of advanced pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct 17(1):27–29PubMedCrossRefGoogle Scholar
  10. 10.
    Al-Mandeel H, Ross S, Robert M et al (2011) Incidence of stress urinary incontinence following vaginal repair of pelvic organ prolapse in objectively continent women. Neurourol Urodyn 30(3):390–394PubMedCrossRefGoogle Scholar
  11. 11.
    Richardson D, Bent A, Ostergard D (1983) The effect of uterovaginal prolapse on urethrovesical pressure dynamics. Am J Obstet Gynecol 146:901–905PubMedGoogle Scholar
  12. 12.
    Bump R, Fantl J, Hurt W (1988) The mechanism of urinary continence in women with severe uterovaginal prolapse: results of barrier studies. Obstet Gynecol 72:291–295PubMedGoogle Scholar
  13. 13.
    Kuribayashi M, Kitagawa Y, Narimoto K et al (2011) Postoperative voiding function in patients undergoing tension-free vaginal mesh procedure for pelvic organ prolapse. Int Urogynecol J 22(10):1299–1303PubMedCrossRefGoogle Scholar
  14. 14.
    Blaivas JG, Groutz A (2000) Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn 19(5):553–564PubMedCrossRefGoogle Scholar
  15. 15.
    Debodinance P, Berrocal J, Clavé H et al (2004) Changing attitudes on the surgical treatment of urogenital prolapse: birth of the tension-free vaginal mesh. J Gynecol Obstet Biol Reprod (Paris) 33(7):577–588CrossRefGoogle Scholar
  16. 16.
    Takeyama M, Uesaka Y, Itoh S et al (2007) Feasibility of the tension-free vaginal mesh procedure using soft polypropylene mesh (Gynemesh PS) Japan. Int Urogynecol J Pelvic Floor Dysfunct 18(Suppl 1):S46–S47Google Scholar
  17. 17.
    Kato K, Suzuki S, Yamamoto S et al (2009) Clinical pathway for tension-free vaginal mesh procedure: evaluation in 300 patients with pelvic organ prolapse. Int J Urol 16(3):314–317PubMedCrossRefGoogle Scholar
  18. 18.
    Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21(1):5–26PubMedCrossRefGoogle Scholar
  19. 19.
    Haessler AL, Lin LL, Ho MH et al (2005) Reevaluating occult incontinence. Curr Opin Obstet Gynecol 17:535–540PubMedCrossRefGoogle Scholar
  20. 20.
    Araki I, Haneda Y, Mikami Y et al (2009) Incontinence and detrusor dysfunction associated with pelvic organ prolapse: clinical value of preoperative urodynamic evaluation. Int Urogynecol J Pelvic Floor Dysfunct 20(11):1301–1306PubMedCrossRefGoogle Scholar
  21. 21.
    Karateke A, Tug N, Cam C et al (2011) Concomitant surgical correction of occult stress urinary incontinence by TOT in patients with pelvic organ prolapse. Eur J Obstet Gynecol Reprod Biol 154(1):105–107PubMedCrossRefGoogle Scholar
  22. 22.
    Liapis A, Bakas P, Georgantopoulou C et al (2011) The use of the pessary test in preoperative assessment of women with severe genital prolapse. Eur J Obstet Gynecol Reprod Biol 155(1):110–113PubMedCrossRefGoogle Scholar
  23. 23.
    McGuire EJ, Lytton B, Pepe V et al (1976) Stress urinary incontinence. Obstet Gynecol 47:255–264PubMedGoogle Scholar
  24. 24.
    Blaivas JG, Olsson CA (1988) Stress incontinence: classification and surgical approach. J Urol 139(4):727–731PubMedGoogle Scholar
  25. 25.
    Fatton B (2009) Is there any evidence to advocate SUI prevention in continent women undergoing prolapse repair? An overview. Int Urogynecol J Pelvic Floor Dysfunct 20(2):235–245PubMedCrossRefGoogle Scholar
  26. 26.
    Brubaker L, Cundiff GW, Fine P et al (2006) Abdominal sacrocolpopexy with Burch colposuspension to reduce urinary stress incontinence. N Engl J Med 354(15):1557–1566PubMedCrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2012

Authors and Affiliations

  • Masato Kuribayashi
    • 1
  • Yasuhide Kitagawa
    • 1
  • Kazutaka Narimoto
    • 1
  • Satoko Urata
    • 1
  • Shohei Kawaguchi
    • 1
  • Mikio Namiki
    • 1
  1. 1.Department of Integrative Cancer Therapy and UrologyKanazawa University, Graduate School of Medical ScienceKanazawaJapan

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