Persistence of urgency and urge urinary incontinence in women with mixed urinary symptoms after midurethral slings: a multivariate analysis

被引:55
作者
Lee, J. K-S [1 ,2 ]
Dwyer, P. L. [1 ]
Rosamilia, A. [2 ]
Lim, Y. N. [1 ]
Polyakov, A. [2 ]
Stav, K. [1 ,3 ]
机构
[1] Mercy Hosp Women, Dept Urogynaecol, Heidelberg, Vic 3084, Australia
[2] Monash Med Ctr, Dept Urogynaecol, Moorabin, Vic, Australia
[3] Assaf Harofeh Med Ctr, Dept Urol, Zerifin, Israel
关键词
Midurethral slings; mixed urinary incontinence; overactive bladder; pelvic organ prolapse; urodynamic studies; FREE VAGINAL TAPE; OVERACTIVE BLADDER SYMPTOMS; PELVIC ORGAN PROLAPSE; TERM-FOLLOW-UP; STRESS-INCONTINENCE; DETRUSOR OVERACTIVITY; TRANSOBTURATOR TAPE; TRANS-OBTURATOR; TRACT SYMPTOMS; OUTCOMES;
D O I
10.1111/j.1471-0528.2011.02915.x
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
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.
引用
收藏
页码:798 / 805
页数:8
相关论文
共 38 条
[1]   Short- and long-term results of the tension-free vaginal tape procedure in the treatment of female urinary incontinence [J].
Ankardal, Maud ;
Heiwall, Bengt ;
Lausten-Thomsen, Niels ;
Carnelid, Jill ;
Milsom, Ian .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 2006, 85 (08) :986-992
[2]   Transobturator tape compared with tension-free vaginal tape for the treatment of stress urinary incontinence [J].
Barber, Matthew D. ;
Kleeman, Steven ;
Karram, Mickey M. ;
Paraiso, Marie Fidela R. ;
Walters, Mark D. ;
Fasavada, Sandip ;
Ellerkmann, Mark .
OBSTETRICS AND GYNECOLOGY, 2008, 111 (03) :611-621
[3]   Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7) [J].
Barber, MD ;
Walters, MD ;
Bump, RC .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2005, 193 (01) :103-113
[4]   Detrusor overactivity and urge urinary incontinence following trans obturator versus midurethral slings [J].
Botros, Sylvia M. ;
Miller, Jay-James R. ;
Goldberg, Roger P. ;
Gandhi, Sanjay ;
Akl, Mohammed ;
Beaumont, Jennifer L. ;
Sand, Peter K. .
NEUROUROLOGY AND URODYNAMICS, 2007, 26 (01) :42-45
[5]   Long-term results of tension-free vaginal tape (TVT) for the treatment of female urinary stress incontinence [J].
Chene, G. ;
Amblard, J. ;
Tardieu, A. S. ;
Escalona, J. R. ;
Viallon, A. ;
Fatton, B. ;
Jacquetin, B. .
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2007, 134 (01) :87-94
[6]   The impact of tension-free vaginal tape on overactive bladder symptoms in women with stress urinary incontinence: Significance of detrusor Overactivity [J].
Choe, Jin Ho ;
Choo, Myung-Soo ;
Lee, Kyu-Sung .
JOURNAL OF UROLOGY, 2008, 179 (01) :214-219
[7]   Predictive factors for overactive bladder symptoms after pelvic organ prolapse surgery [J].
de Boer, Tiny A. ;
Kluivers, Kirsten B. ;
Withagen, Mariella I. J. ;
Milani, Alfredo L. ;
Vierhout, Mark E. .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2010, 21 (09) :1143-1149
[8]   Long-term results of tension-free vaginal tape for female urinary incontinence: Follow up over 6 years [J].
Deffieux, Xavier ;
Donnadieu, Anne Claire ;
Porcher, Raphael ;
Gervaise, Amelie ;
Frydman, Rene ;
Fernandez, Herve .
INTERNATIONAL JOURNAL OF UROLOGY, 2007, 14 (06) :521-526
[9]  
Delorme E, 2001, PROG UROL, V11, P1306
[10]   Mixed incontinence: definitions, outcomes, and interventions [J].
Dmochowski, R ;
Staskin, D .
CURRENT OPINION IN UROLOGY, 2005, 15 (06) :374-379