The negative predictive value of preoperative urodynamics for stress urinary incontinence following prolapse surgery

Sierra, Tania; Sullivan, Gina; Leung, Katherine; Flynn, Michael K.

doi:10.1007/s00192-018-03864-y

Cited by 9 publications

(6 citation statements)

References 13 publications

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“…The previous model did not rely upon urodynamic testing variables, despite the fact that such test results could have a significant role in detecting and predicting SUI. [ 40 , 41 ] In a model used to predict urinary incontinence risk described by Jelovsek et al, an online calculator had been designed for women undergoing POP surgery that had predicted incontinence risk using statistical and regression models. The results of that study demonstrated that the model was more accurate than stress testing (area under the curve = 0.72 vs. 0.54, p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…In this study, 12 factors were used for risk calculation modeling (including age, BMI, diabetes, pessary test, history of surgery, urethral obstruction [moderate or more severe], and parity, along with urodynamic variables including abdominal leak point pressures, functional urethral length, maximum urethral closure pressure and lower urinary tract obstruction) in order to create a more comprehensive model for physicians than those used in a previous model [2] which merely included 6 factors (age, BMI, parity, diabetes, pessary test, and urine leakage associated with a feeling of urgency). The previous model did not rely upon urodynamic testing variables, despite the fact that such test results could have a significant role in detecting and predicting SUI [40,41] . In a model used to predict urinary incontinence risk described by Jelovsek et al, an online calculator had been designed for women undergoing POP surgery that had predicted incontinence risk using statistical and regression models.…”

Section: Discussionmentioning

confidence: 99%

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

2021

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Background: Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are common conditions affecting women's health and quality of life. In 50% of cases, SUI occurs after POP surgery, which is called de novo SUI. Predicting the risk of de novo SUI is a complex multi-attribute decision-making process. The current study made available a Decision Support System in the form of a fuzzy calculator web-based application to help surgeons predict the risk of de novo SUI. Materials and methods: We first identified 12 risk factors and the diagnostic criteria for de novo SUI by means of a systematic review of the literature. Then based upon an expert panel, all risk factors were prioritized. A set of 232 fuzzy rules for the prediction of de novo SUI was determined. A fuzzy expert system was developed using MATLAB software and Mamdani Inference System. The risk prediction model was then evaluated using retrospective data extracted from 30 randomly selected medical records of female patients over the age of 50 without symptoms of urinary incontinence who had undergone POP surgery. Finally, the proposed results of the predictive system were compared with the results of retrospective medical record data review. Results: The results of this online calculator show that the accuracy of this risk prediction model, at more than 90%, compared favorably to other SUI risk prediction models. Conclusions: A fuzzy logic-based clinical Decision Support System in the form of an online calculator for calculating SUI prognosis after POP surgery in women can be helpful in predicting de novo SUI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

2021

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“…Bladders were lled with room-temperature sterile water at 50 ml/min. Stress test including cough and Valsalva efforts was performed at bladder volumes of 100, 200, 300, and 500 ml (or cystometric capacity) 15 . Urodynamic parameters included the maximal urine ow rate (MUFR, Qmax), average urine ow rate (AUFR, Qave), maximal bladder volume (MBV), maximal detrusor pressure (MDP), voiding time, detrusor pressure at MUFR (Pdet Qmax), maximal urethral closure pressure (MUCP), Valsalva leak point pressure (VLPP) and Post Void Residual (PVR).…”

Section: Methodsmentioning

confidence: 99%

The Value of Preoperative Urodynamics in Surgery Decision for Pelvic Organ Prolapse Patients with Occult Stress Urinary Incontinence

Xia

et al. 2020

Preprint

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This retrospective cohort study aims to explore the clinical value of urodynamics in evaluating lower urinary tract function in pelvic organ prolapse (POP) patients, and to investigate the urodynamic characteristics of POP patients with occult stress urinary incontinence (OSUI) in whom moderate or above postoperative SUI eventually occurred after prolapse surgery. The medical records of 626 advanced POP patients who underwent vaginal pelvic reconstructive surgery were analyzed. The patients with anterior compartment prolapse were more susceptible to urodynamic changes than those with apical or posterior compartment prolapse (95.1% vs. 40.15%). The proportion of patients with urodynamic abnormality was increased with prolapse severity (68.8% vs. 78.6%). After 3 months, the incidence of moderate or severe postoperative urinary incontinence in the OSUI patients was 20%, while it is 2.8% in non-OSUI patients. In subgroup analysis of OSUI patients, the urodynamics of patients with moderate or above postoperative urinary leakage showed significantly lower Valsalva leak point pressure (VLPP), maximum urethral closure pressure (MUCP), maximal bladder volume (MBV) and maximum urine flow rate (MUFR). For POP patients with OSUI, anti-incontinence surgery is only recommended for whom with lower VLPP, MUCP, MBV and MUFR to avoid the risk and costs of secondary surgery or overtreatment.

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“…To the Editor, We appreciate the interest showed by Dr. Tsun-Wen and his colleagues in our manuscript [1]. Indeed, we did not include transvaginal mesh surgeries in our retrospective study as they were not performed at our institution during the study period.…”

mentioning

confidence: 99%

The negative predictive value of preoperative urodynamics for stress urinary incontinence following prolapse surgery

Cited by 9 publications

References 13 publications

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

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

The Value of Preoperative Urodynamics in Surgery Decision for Pelvic Organ Prolapse Patients with Occult Stress Urinary Incontinence

Letter to the editor: The negative predictive value of preoperative urodynamics for stress urinary incontinence following prolapse surgery

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