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Outcome of coexistent overactive bladder symptoms in women with urodynamic urinary incontinence following anti-incontinence surgery

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Abstract

Introduction and hypothesis

The objective was to investigate the outcome of stress urinary incontinence (SUI) and overactive bladder (OAB) symptoms in women with urodynamic stress incontinence (USI) after transobturator sling procedures (TOTs).

Methods

We evaluated 109 consecutive patients with USI, who had undergone TOT in a tertiary hospital between 2012 and 2014. All patients received evaluations, including structured urogynecological questionnaires and pelvic organ prolapse quantification examination before, and 3 and 12 months after surgery. One-hour pad test and urodynamic testing were performed before and 3–6 months postoperatively. Patient demographics, lower urinary tract symptoms, and urodynamic results were analyzed between pure USI and USI with OAB symptoms.

Results

Persistent SUI occurred in 8 patients at 3 months (7.3 %) and 7 patients at 12 months (6.4 %) postoperatively. The most common OAB symptom was frequency (54.1 %), followed by urgency urinary incontinence (52.3 %), urinary urgency (42.2 %), and nocturia (33 %). Most of these OAB symptoms were resolved at the 3-month and 12-month follow-ups both in patients treated with TOT only and in those treated with TOT combined with other pelvic surgeries. There was no significant difference in the preoperative urodynamic changes between patients with pure USI and USI without OAB groups. However, postoperative urodynamic results showed a significant decrease in the maximal urethral closure pressure in the group of patients with USI and OAB symptoms, but no significant urodynamic changes in the group with pure USI.

Conclusions

Coexistent OAB symptoms are common in women who were diagnosed with USI and most of these symptoms may resolve 3 and 12 months after TOT.

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Abbreviations

DO:

Detrusor overactivity

IIQ-7:

The short form of the Incontinence Impact Questionnaire

LUTS:

Lower urinary tract symptoms

MUCP:

Maximal urethral closure pressure

MUI:

Mixed urinary incontinence

OAB:

Overactive bladder

POP:

Pelvic organ prolapse

SUI:

Stress urinary incontinence

TOT:

Transobturator sling procedure

TVT:

Tension-free vaginal tape

UDI-6:

The short form of the Urogenital Distress Inventory

USI:

Urodynamic stress incontinence

UUI:

Urgency urinary incontinence

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    Authors and Affiliations

    1. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, 5, Fu-Shin Street, Kweishan, Taoyuan, Taiwan, 333

      Ching-Chung Liang, Wu-Chiao Hsieh & LuLu Huang

    2. College of Medicine, Chang Gung University, Taoyuan, Taiwan

      Ching-Chung Liang

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    1. Ching-Chung Liang
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    2. Wu-Chiao Hsieh
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    3. LuLu Huang
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    Correspondence to Ching-Chung Liang.

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    Ching-Chung Liang and Wu-Chiao Hsieh contributed equally to this work

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    Liang, CC., Hsieh, WC. & Huang, L. Outcome of coexistent overactive bladder symptoms in women with urodynamic urinary incontinence following anti-incontinence surgery. Int Urogynecol J 28, 605–611 (2017). https://doi.org/10.1007/s00192-016-3153-y

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