Risk factors for persistent, de novo and overall overactive bladder syndrome after surgical prolapse repair

Objective: Overactive bladder (DAB) symptoms are frequently associated with pelvic organ prolapse (POP) and both postoperative improvement and de novo onset of DAB symptoms have been described. The aim of the study is to identify risk factors for persistent, de novo and overall postoperative DAB after POP repair. Study design: This was a retrospective study including patients who underwent primary POP surgery. Medical interview, urogenital examination and urodynamics were performed preoperatively; patients were examined one and six months after surgery and then yearly. Results: 518 patients were included. 36.1% of women preoperatively complained of DAB symptoms while detrusor overactivity was found in 20.5%. The rate of persistent and de novo OAB after surgery were respectively 14.1% and 13.5%. Multivariate analysis found age, BMI, preoperative DAB, sling placement and postoperative SUI as independent risk factors for overall OAB after surgery. Moreover, preoperative DAB and postoperative constipations were associated with DAB persistence after surgery. Finally, age, sling placement, postoperative SUI and voiding symptoms were independently associated with de novo DAB. Conclusion: Preoperative DAB symptoms are associated with DAB persistence after POP surgery, while age and sling placement correlate with de novo OAB. Finally, increased BMI is related to postoperative DAB. (C) 2018 Elsevier B.V. All rights reserved.