This study was based on data collected from the Danish Urogynaecological Database. Data were collected from 2013 to 2016 to explore the prevalence of and risk factors for de novo urinary incontinence (UI) after pelvic organ prolapse surgery. Inclusion criteria included urinary continent women who underwent pelvic organ prolapse surgery. Urinary continence was defined as a total score of 0 and women who answered ‘never’ to ‘When does urine leak?’ using the International Consultation on Incontinence Questionnaire-Urinary Incontinence-short form (ICIQ-UI-sf). In the post-operative phase, women were classified as continent or with stress urinary incontinence (SUI), urgency urinary incontinence (UUI), mixed urinary incontinence (MUI) or undefined UI.

There were 1198 women included in the study. The authors concluded that the overall risk of de novo UI after pelvic organ prolapse surgery was 15%. Forty-five per cent had SUI, 30% had UUI, 16% had MUI and 10% had undefined UI. Twenty-three per cent of women with a body mass index ≥ 30 developed de novo UI. Interestingly, age, compartment and pelvic organ prolapse stage were not associated with de novo UI.

Strengths of this study include the large cohort of included patients. Being a national database with mandatory registration for all departments that perform urogynaecological procedures in Denmark, this ensures high validity. However, one must note that reporting on data from the pre- and post-operative assessments might be varied from department to department. Additionally, the method of post-operative assessment may vary; while some departments invited women to attend, others offered a telephone review with a specialist nurse, therefore allowing for response bias.