Literature DB >> 17016798

Does urodynamic investigation improve outcome in patients undergoing prolapse surgery?

J P W R Roovers1, J O E H van Laar, C Loffeld, G L Bremer, B W Mol, M Y Bongers.   

Abstract

AIMS: Without solid evidence, it has been advocated to perform urodynamic investigation in all patients scheduled for prolapse surgery. If urodynamic investigations were to be valuable in the diagnostic work-up, patients with normal and abnormal findings would have different treatment results. Our policy to never combine prolapse surgery and stress-incontinence surgery allowed us to study whether incontinence after surgery can be predicted from urodynamic investigation results.
METHODS: A retrospective study was performed in consecutive patients undergoing vaginal prolapse surgery (anterior colporraphy and/or posterior colporraphy, and/or vaginal hysterectomy) between 2002 and 2004. All patients underwent pre-operative urodynamic investigation, including filling cystometry, urethral pressure profile measurement, and free flow cystometry. Data were collected from the files about medical history, findings at pelvic examination, findings at urodynamic investigation and presence of stress- and/or urge-incontinence after surgery.
RESULTS: We studied 76 patients, of whom 5 (7%) patients reported stress-incontinence and 5 (7%) patients reported urge-incontinence after surgery. Findings at urodynamic investigation could not predict the presence of stress- or urge-incontinence after surgery. Likelihood ratios (LR) of prior presence of urge and stress-incontinence for the presence of post-operative urge- and stress-incontinence were 4.5 and 1.2, respectively. Of all findings at urodynamic investigation, only negative transmission during cough test was associated with presence of stress-incontinence (LR = 1.5).
CONCLUSIONS: The prevalence of incontinence after prolapse surgery is low. None of the investigated parameters of the urodynamic investigation tests was associated with the presence of urinary incontinence after surgery. (c) 2007 Wiley-Liss, Inc.

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Year:  2007        PMID: 17016798     DOI: 10.1002/nau.20328

Source DB:  PubMed          Journal:  Neurourol Urodyn        ISSN: 0733-2467            Impact factor:   2.696


  6 in total

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Authors:  Benjamin E Dillon; Philippe E Zimmern
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2.  International Urogynecology Consultation Chapter 1 Committee 5: relationship of pelvic organ prolapse to associated pelvic floor dysfunction symptoms: lower urinary tract, bowel, sexual dysfunction and abdominopelvic pain.

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3.  Outcomes following vaginal prolapse repair and mid urethral sling (OPUS) trial--design and methods.

Authors:  John Wei; Ingrid Nygaard; Holly Richter; Morton Brown; Matthew Barber; Kimberly Kenton; Charles Nager; Joseph Schaffer; Anthony Visco; Anne Weber
Journal:  Clin Trials       Date:  2009-04       Impact factor: 2.486

Review 4.  Is there any evidence to advocate SUI prevention in continent women undergoing prolapse repair? An overview.

Authors:  B Fatton
Journal:  Int Urogynecol J Pelvic Floor Dysfunct       Date:  2008-10-21

5.  A web-based fuzzy risk predictive-decision model of de novo stress urinary incontinence in women undergoing pelvic organ prolapse surgery.

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Journal:  Curr Urol       Date:  2021-08-09

6.  The evidence for urodynamic investigation of patients with symptoms of urinary incontinence.

Authors:  Peter F Rosier
Journal:  F1000Prime Rep       Date:  2013-03-04
  6 in total

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