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Persistence of urgency and urge urinary incontinence in women with mixed urinary symptoms after midurethral slings: a multivariate analysis.
BJOG. 2011 Jun; 118(7):798-805.BJOG

Abstract

OBJECTIVE

To determine risk factors for persistence of urgency or urge urinary incontinence following midurethral sling surgery.

DESIGN

Prospective cohort study.

SETTING

Tertiary referral Urogynaecology Unit.

SAMPLE

A total of 754 consecutive women with stress urinary incontinence (SUI) and urgency; and 514 women with SUI and urge urinary incontinence (UUI) who underwent midurethral sling with a mean follow up of 50 months.

METHODS

Women with persistent urgency or UUI at long-term follow up were compared with those whose symptoms had resolved, using multivariate analysis to determine the risk factors for persistent symptoms.

MAIN OUTCOMES MEASURES

Odd ratios (OR) of independent risk factors for persistent urgency or UUI.

RESULTS

Persistent urgency (304/754, 40%) and UUI (166/514, 32%) were common. Coexistent detrusor overactivity (OR 2.04, 95% CI 1.39-3.01), baseline symptom severity (OR 1.41, 95% CI 1.10-1.78) and age (OR 1.03, 95% CI 1.02-1.04) increased the risk of persistent urgency, while transobturator sling surgery (OR 0.61, 95% CI 0.39-094) and concomitant prolapse surgery (OR 0.54, 95% CI 0.38-0.75) decreased the risk. For UUI detrusor overactivity (OR 1.86, 95% CI 1.18-2.93), baseline symptom severity (OR 1.88, 95% CI 1.38-2.56), previous incontinence surgery (OR 2.18, 95% CI 1.28-3.70) increased the risk of persistence, whereas apical prolapse surgery (OR 0.33, 95% CI 0.15-0.70) decreased the risk. Women were more likely not to recommend surgery when they experienced persistent urgency (15.8% versus 2.7%, P < 0.0001) or UUI (24.7% versus 2.9%, P < 0.0001).

CONCLUSIONS

Urodynamic parameters, baseline urgency symptom severity, midurethral sling route and concomitant prolapse operation are important predictors of persistent urgency or UUI following midurethral sling.

Authors+Show Affiliations

Department of Urogynaecology, Mercy Hospital for Women, Heidelberg. Vic., Australia. joseph.lee@southernhealth.org.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21392244

Citation

Lee, J K-S, et al. "Persistence of Urgency and Urge Urinary Incontinence in Women With Mixed Urinary Symptoms After Midurethral Slings: a Multivariate Analysis." BJOG : an International Journal of Obstetrics and Gynaecology, vol. 118, no. 7, 2011, pp. 798-805.
Lee JK, Dwyer PL, Rosamilia A, et al. Persistence of urgency and urge urinary incontinence in women with mixed urinary symptoms after midurethral slings: a multivariate analysis. BJOG. 2011;118(7):798-805.
Lee, J. K., Dwyer, P. L., Rosamilia, A., Lim, Y. N., Polyakov, A., & Stav, K. (2011). Persistence of urgency and urge urinary incontinence in women with mixed urinary symptoms after midurethral slings: a multivariate analysis. BJOG : an International Journal of Obstetrics and Gynaecology, 118(7), 798-805. https://doi.org/10.1111/j.1471-0528.2011.02915.x
Lee JK, et al. Persistence of Urgency and Urge Urinary Incontinence in Women With Mixed Urinary Symptoms After Midurethral Slings: a Multivariate Analysis. BJOG. 2011;118(7):798-805. PubMed PMID: 21392244.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Persistence of urgency and urge urinary incontinence in women with mixed urinary symptoms after midurethral slings: a multivariate analysis. AU - Lee,J K-S, AU - Dwyer,P L, AU - Rosamilia,A, AU - Lim,Y N, AU - Polyakov,A, AU - Stav,K, Y1 - 2011/03/10/ PY - 2011/3/12/entrez PY - 2011/3/12/pubmed PY - 2011/12/13/medline SP - 798 EP - 805 JF - BJOG : an international journal of obstetrics and gynaecology JO - BJOG VL - 118 IS - 7 N2 - OBJECTIVE: To determine risk factors for persistence of urgency or urge urinary incontinence following midurethral sling surgery. DESIGN: Prospective cohort study. SETTING: Tertiary referral Urogynaecology Unit. SAMPLE: A total of 754 consecutive women with stress urinary incontinence (SUI) and urgency; and 514 women with SUI and urge urinary incontinence (UUI) who underwent midurethral sling with a mean follow up of 50 months. METHODS: Women with persistent urgency or UUI at long-term follow up were compared with those whose symptoms had resolved, using multivariate analysis to determine the risk factors for persistent symptoms. MAIN OUTCOMES MEASURES: Odd ratios (OR) of independent risk factors for persistent urgency or UUI. RESULTS: Persistent urgency (304/754, 40%) and UUI (166/514, 32%) were common. Coexistent detrusor overactivity (OR 2.04, 95% CI 1.39-3.01), baseline symptom severity (OR 1.41, 95% CI 1.10-1.78) and age (OR 1.03, 95% CI 1.02-1.04) increased the risk of persistent urgency, while transobturator sling surgery (OR 0.61, 95% CI 0.39-094) and concomitant prolapse surgery (OR 0.54, 95% CI 0.38-0.75) decreased the risk. For UUI detrusor overactivity (OR 1.86, 95% CI 1.18-2.93), baseline symptom severity (OR 1.88, 95% CI 1.38-2.56), previous incontinence surgery (OR 2.18, 95% CI 1.28-3.70) increased the risk of persistence, whereas apical prolapse surgery (OR 0.33, 95% CI 0.15-0.70) decreased the risk. Women were more likely not to recommend surgery when they experienced persistent urgency (15.8% versus 2.7%, P < 0.0001) or UUI (24.7% versus 2.9%, P < 0.0001). CONCLUSIONS: Urodynamic parameters, baseline urgency symptom severity, midurethral sling route and concomitant prolapse operation are important predictors of persistent urgency or UUI following midurethral sling. SN - 1471-0528 UR - https://www.unboundmedicine.com/medline/citation/21392244/Persistence_of_urgency_and_urge_urinary_incontinence_in_women_with_mixed_urinary_symptoms_after_midurethral_slings:_a_multivariate_analysis_ L2 - https://doi.org/10.1111/j.1471-0528.2011.02915.x DB - PRIME DP - Unbound Medicine ER -