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Pre-operative opening detrusor pressure is predictive of detrusor overactivity following TVT in patients with pre-operative mixed urinary incontinence.
Neurourol Urodyn 2009; 28(1):82-5NU

Abstract

AIMS

To determine if specific pre-operative urodynamic parameters could predict detrusor overactivity following TVT in patients with urodynamic mixed incontinence.

METHODS

Notes of women with detrusor overactivity (DO) and urodynamic stress incontinence (USI) before undergoing tension-free vaginal tape (TVT) surgery were retrospectively reviewed. Patients underwent clinical evaluation pre-operatively including history, examination, and conventional urodynamic studies and were treated with pelvic floor exercises and anti-cholinergic medication. Those with persistent stress urinary incontinence (SUI) underwent TVT. Patients were re-assessed after at least 6 months post-operatively. Pre- and post-operative opening and closing detrusor pressure, and detrusor pressure at maximum flow were recorded retrospectively from pre-operative urodynamics traces by two clinicians independently and compared to the patients' post-operative symptoms and urodynamic diagnosis.

RESULTS

Fifty-one women were reviewed. Forty-six of the 51 attended follow-up and 35/51 agreed to conventional urodynamic studies. Seventeen of the 35 reported OAB symptoms, and 18/35 were asymptomatic. Nineteen of the 35 women had DO and 16/35 had normal urodynamic studies (NUDS). The median pre-operative opening detrusor pressure was higher in women with overactive bladder symptoms post-operatively. The median pre-operative opening detrusor pressure in women with DO post-operatively was 33.0 cmH(2)O and the median pre-operative opening detrusor pressure in those with NUDS post-operatively was 16 cmH(2)O (15.0-23.0 cmH(2)O) (P < 0.05 Mann-Whitney U-test).

CONCLUSIONS

Higher numbers of patients are required to demonstrate the value of opening detrusor pressure in predicting post-operative overactive bladder symptoms. Opening detrusor pressure is predictive of post-operative DO after TVT.

Authors+Show Affiliations

Department of Urogynaecology, St. Mary's Hospital, London, United Kingdom. drpanayi@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19089898

Citation

Panayi, D C., et al. "Pre-operative Opening Detrusor Pressure Is Predictive of Detrusor Overactivity Following TVT in Patients With Pre-operative Mixed Urinary Incontinence." Neurourology and Urodynamics, vol. 28, no. 1, 2009, pp. 82-5.
Panayi DC, Duckett J, Digesu GA, et al. Pre-operative opening detrusor pressure is predictive of detrusor overactivity following TVT in patients with pre-operative mixed urinary incontinence. Neurourol Urodyn. 2009;28(1):82-5.
Panayi, D. C., Duckett, J., Digesu, G. A., Camarata, M., Basu, M., & Khullar, V. (2009). Pre-operative opening detrusor pressure is predictive of detrusor overactivity following TVT in patients with pre-operative mixed urinary incontinence. Neurourology and Urodynamics, 28(1), pp. 82-5. doi:10.1002/nau.20576.
Panayi DC, et al. Pre-operative Opening Detrusor Pressure Is Predictive of Detrusor Overactivity Following TVT in Patients With Pre-operative Mixed Urinary Incontinence. Neurourol Urodyn. 2009;28(1):82-5. PubMed PMID: 19089898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-operative opening detrusor pressure is predictive of detrusor overactivity following TVT in patients with pre-operative mixed urinary incontinence. AU - Panayi,D C, AU - Duckett,J, AU - Digesu,G A, AU - Camarata,M, AU - Basu,M, AU - Khullar,V, PY - 2008/12/18/entrez PY - 2008/12/18/pubmed PY - 2009/2/6/medline SP - 82 EP - 5 JF - Neurourology and urodynamics JO - Neurourol. Urodyn. VL - 28 IS - 1 N2 - AIMS: To determine if specific pre-operative urodynamic parameters could predict detrusor overactivity following TVT in patients with urodynamic mixed incontinence. METHODS: Notes of women with detrusor overactivity (DO) and urodynamic stress incontinence (USI) before undergoing tension-free vaginal tape (TVT) surgery were retrospectively reviewed. Patients underwent clinical evaluation pre-operatively including history, examination, and conventional urodynamic studies and were treated with pelvic floor exercises and anti-cholinergic medication. Those with persistent stress urinary incontinence (SUI) underwent TVT. Patients were re-assessed after at least 6 months post-operatively. Pre- and post-operative opening and closing detrusor pressure, and detrusor pressure at maximum flow were recorded retrospectively from pre-operative urodynamics traces by two clinicians independently and compared to the patients' post-operative symptoms and urodynamic diagnosis. RESULTS: Fifty-one women were reviewed. Forty-six of the 51 attended follow-up and 35/51 agreed to conventional urodynamic studies. Seventeen of the 35 reported OAB symptoms, and 18/35 were asymptomatic. Nineteen of the 35 women had DO and 16/35 had normal urodynamic studies (NUDS). The median pre-operative opening detrusor pressure was higher in women with overactive bladder symptoms post-operatively. The median pre-operative opening detrusor pressure in women with DO post-operatively was 33.0 cmH(2)O and the median pre-operative opening detrusor pressure in those with NUDS post-operatively was 16 cmH(2)O (15.0-23.0 cmH(2)O) (P < 0.05 Mann-Whitney U-test). CONCLUSIONS: Higher numbers of patients are required to demonstrate the value of opening detrusor pressure in predicting post-operative overactive bladder symptoms. Opening detrusor pressure is predictive of post-operative DO after TVT. SN - 1520-6777 UR - https://www.unboundmedicine.com/medline/citation/19089898/Pre_operative_opening_detrusor_pressure_is_predictive_of_detrusor_overactivity_following_TVT_in_patients_with_pre_operative_mixed_urinary_incontinence_ L2 - https://doi.org/10.1002/nau.20576 DB - PRIME DP - Unbound Medicine ER -