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Occult incontinence as predictor for postoperative stress urinary incontinence following pelvic organ prolapse surgery

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Abstract

Introduction and hypothesis

Recommending prophylactic anti-incontinence procedures to continent women undergoing surgery for pelvic organ prolapse (POP) is controversial. We hypothesized that testing for occult incontinence before surgery using four different tests and three defined test combinations would identify individual women at risk for postoperative stress urinary incontinence (POSUI). The diagnostic accuracy of these tests and test combinations were evaluated.

Methods

We tested 137 women before and after surgery. Fisher’s exact test was used when evaluating associations between test results and outcomes. The validity of each test and test combinations was calculated.

Results

We found a statistically significant association between occult incontinence and POSUI in two tests and all test combinations. However, all tests and test combinations displayed poor performance when predicting at individual levels.

Conclusions

This study confirms a positive association between occult incontinence and POSUI. Occult incontinence does not, however, adequately identify individual women in need of prophylactic anti-incontinence surgery when undergoing POP repair.

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Acknowledgement

Study assistance from Øystein Bjørnerud, urotechnician at Department of Urology, Oslo University Hospital, contributing to the preoperative testing and data collection, is greatly appreciated.

Financial Disclosure/Conflicts of Interest

R. Svenningsen: None; Ellen Borstad has received speaker fees from Pfizer, Astellas, and Lilly and served on advisory boards for Astellas and Lilly; Anny Spydslaug has received speaker fees and served as paid consultant for Pfizer; L. Sandvik: None; AC Staff: None

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Authors and Affiliations

  1. Department of Gynaecology, Oslo University Hospital, Ulleval, PB 4956, Nydalen, 0424, Oslo, Norway

    Rune Svenningsen, Ellen Borstad, Anny Elisabeth Spydslaug & Anne Cathrine Staff

  2. Unit of Biostatistics and Epidemiology, Oslo University Hospital, Ulleval, Oslo, Norway

    Leiv Sandvik

  3. Faculty of Medicine, University of Oslo, Oslo, Norway

    Leiv Sandvik & Anne Cathrine Staff

Authors
  1. Rune Svenningsen
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  2. Ellen Borstad
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  3. Anny Elisabeth Spydslaug
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  4. Leiv Sandvik
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  5. Anne Cathrine Staff
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Corresponding author

Correspondence to Rune Svenningsen.

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Svenningsen, R., Borstad, E., Spydslaug, A.E. et al. Occult incontinence as predictor for postoperative stress urinary incontinence following pelvic organ prolapse surgery. Int Urogynecol J 23, 843–849 (2012). https://doi.org/10.1007/s00192-012-1764-5

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  • DOI: https://doi.org/10.1007/s00192-012-1764-5

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