Mixed incontinence and cystocele: postoperative urge symptoms are not predicted by preoperative urodynamics

Wolter, Christopher E.; Kaufman, Melissa R.; Duffy, John W.; Scarpero, Harriette M.; Dmochowski, Roger R.

doi:10.1007/s00192-010-1261-7

Cited by 25 publications

(7 citation statements)

References 14 publications

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“…The discrepancy in cure rates of DO and OAB was a result of the difference in physician -patient perception of cure. Similarly, Wolter, et al 17 shows 35% of patients with MUI had DO on UDS while 24% had no symptoms of OAB but had DO. Gilleran, et al 28 looked into urodynamic findings before and after prolapse reduction, showing that the presence of DO remained constant.…”

Section: Discussionmentioning

confidence: 87%

“…The cure rates of the present study were almost comparable with other published reports. Wolter, et al 17 demonstrates resolution of MUI in 63% (34/70) of patients after correction of grade 3-4 cystocele with sling insertion. www.nature.com/scientificreports www.nature.com/scientificreports/ Nguyen and Bhatia 18 shows 63% (24/38) of patients with resolution of urge urinary incontinence after surgical prolapse repair.…”

Section: Discussionmentioning

confidence: 99%

“…Parkinson's disease and cerebrovascular accidents, pre-operative (MUCP ≥ 60 cm H 2 O, maximum flow rate < 15 ml, Dmax ≥ 20 cm H 2 O), and PVR > 200 ml 27 cause persistence of DO after PRS. Concomitant sling surgery is also a known factor to increase the rate of DO or OAB 17 . The present study, however, did not show significant increase in DO or symptoms of urgency to the MUS group.…”

Section: Discussionmentioning

confidence: 99%

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Urodynamics mixed type urinary incontinence with advanced pelvic organ prolapse, management and outcomes

Uy-Patrimonio²,

Kao

et al. 2020

Sci Rep

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patients with pelvic organ prolapse (pop) often have accompanying lower urinary tract symptoms. Symptoms such as stress urinary incontinence(SUi-UD) and detrusor overactivty(Do) would co-exist in a number of patients. Management entails relieving the obstructive element. to determine the clinical outcome of patients with urodynamics mixed type urinary incontinence(MUi-U) after vaginal pelvic reconstructive surgery(PRS), a retrospective study was conducted. MUI-U was defined as having urodynamic findings of both of DO/DOI (derusor overactivity incontinence) and SUI-UD. Main outcome measures: Objective cure-absence of involuntary detrusor contraction on filling cystometry and no demonstrable leakage of urine during increased abdominal pressure; Subjective cure-assessment index score of <1 on UDI-6 question #2 and #3. Of the 82 patients evaluated, 14 underwent vaginal PRS with concomitant mid-urethral sling(MUS) insertion while 68 had vaginal PRS alone. Pre-operatively, 49(60%) patients had stage III and 33(40%) had stage IV prolapse. Post-operatively, 1-year data shows an objective cure of 56% (46/82) and subjective cure of 54% (44/82). MUI-U was significantly improved. improvement of SUi UD and results of the 1-hour pad test were more pronounced in patients with concomitant MUS insertion. ergo, vaginal pRS cures symptoms of MUi-U in >50% of patients and concomitant MUS can be offered to SUI predominant MUI. Mixed urinary incontinence (MUI) alone has been the leading cause of urinary incontinence in women above 65 years old. The ten-year cumulative incidence of urinary incontinence rates MUI as the first reported symptom in 37.2% of elderly patients 1. The International Urogynecological Association (IUGA) and International Continence Society (ICS) define MUI as the complaint of involuntary leakage of urine associated with exertion, sneezing, or coughing, as well as leakage associated with urgency 2. The cause of which is due to striated muscle atrophy, estrogen deficiency, abnormalities in histomorphology, and microstructural changes 3. Diagnosis of MUI through urodynamic studies pose a great challenge, since results fail to correlate with patient's symptoms, which lead to under diagnosis. Management of these group patients has generally been based on the predominant symptom that the patients report as the most bothersome 4. On the other hand, patients with pelvic organ prolapse (POP) often have lower urinary tract symptoms (LUTS). The use of urodynamic study for pre-operative evaluation of patients with POP becomes mandatory per recommendation by International Consultation on Incontinence 5. Urodynamic studies unmask occult stress urinary incontinence (SUI-UD) and identify women with concomitant detrusor overactivity (DO) and overt SUI-UD. Women with DO and SUI-UD are considered to have mixed type urinary incontinence (MUI-U). The incidence of MUI in patients with POP is 34.3% 6. Relieving the obstructive element becomes the main focus of management

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Urodynamics mixed type urinary incontinence with advanced pelvic organ prolapse, management and outcomes

Uy-Patrimonio²,

Kao

et al. 2020

Sci Rep

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“…In any case both parameters are related (ie, the patients with DO have a lower bladder capacity). On the contrary, Wolter et al describe that pre‐operative DO did not act as risk factor for post‐operative urge‐incontinence, so that they think that pre‐operative urodynamics is not useful to predict incontinence surgery outcome. However this study had a remarkable limitation, because they do not perform post‐operative urodynamic study.…”

Section: Discussionmentioning

confidence: 98%

Effect of pelvic organ prolapse repair on detrusor overactivity in women following incontinence surgery: A multivariate analysis

Chamorro

Salinas-Casado

María

et al. 2017

Neurourology and Urodynamics

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“…c. Wolter обнаружил ГД на предоперационной цистометрии только у 33 % женщин со смешанным НМ и цистоцеле. Несмотря на то что пациентки со смешанным НМ более часто, чем женщины со стрессовым НМ, предъявляли ургентные жалобы после хирургической коррекции пролапса, предоперационное кУДИ не было предиктором этого осложнения [38]. H.K.…”

Section: диагностика дисфункций нижних мочевых путей у женщин с пролаunclassified

Lower urinary tract dysfunction in women with pelvic organ prolapse: diagnostic problems

Rusina

Ивановна

2018

Z.akus.zen.bolezn

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Lower urinary tract dysfunction (LUTD) is often the main reason for patients with pelvic organ prolapse (POP) to see a doctor. LUTD can be caused by a variety of pathophysiological reasons that are underestimated in preoperative examination and are not taken into account when planning treatment. Application of examination algorithms using modern urodynamic methods in patients with LUTD and POP can lead to an improvement in the functional results of treatment. (For citation: Rusina EI. Lower urinary tract dysfunction in women with pelvic organ prolapse: Diagnostic problems. Journal of Obstetrics and Women’s Diseases. 2018;67(4):4-12. doi: 10.17816/JOWD6744-12).

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Mixed incontinence and cystocele: postoperative urge symptoms are not predicted by preoperative urodynamics

Abstract: Cystocele patients with MUI are at significant risk for postoperative urge symptoms regardless of DO, and counseling regarding persistent urgency is imperative.

Cited by 25 publications

References 14 publications

Urodynamics mixed type urinary incontinence with advanced pelvic organ prolapse, management and outcomes

Urodynamics mixed type urinary incontinence with advanced pelvic organ prolapse, management and outcomes

Effect of pelvic organ prolapse repair on detrusor overactivity in women following incontinence surgery: A multivariate analysis

Lower urinary tract dysfunction in women with pelvic organ prolapse: diagnostic problems

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