Authors: Xiaochen Song Lan Zhu Jing Ding
Publish Date: 2015/06/02
Volume: 34, Issue: 3, Pages: 361-367
Abstract
Part of the patients with pelvic organ prolapse but without symptoms of stress urinary incontinence SUI may demonstrate SUI after prolapse surgery occult SUI and no optimal preoperative screening method is currently available for it The aim of this study was to estimate the value of the preoperative 1h pad test with pessary insertion for predicting the need for a midurethral sling MUS following prolapse surgeryTwo hundred and six patients were enrolled for advanced prolapse without complaining of urinary incontinence UI in this prospective cohort study Exclusion criteria included prior or concomitant antiincontinence surgery Preoperatively a stress test the 1h pad test and uroflowmetry were performed with prolapse reduction Primary outcome was postoperative de novo UI Median followup was 31 months range 12–48 monthsOf the 206 patients 45 218 had evidence of occult SUI preoperatively 62 301 exhibited de novo UI postoperatively and only 13 63 opted MUSs Patients with occult SUI experienced higher de novo UI rate 533 vs 236 P = 0000 The OSUI and concomitant hysterectomy were identified as independent risk factors related to de novo UI P = 0000 P = 0044 We performed receiver operating characteristic ROC curve analysis to evaluate the value of preoperative 1h pad test The area under ROC curve was 0816 ± 0085 95 CI 0649–0983 the cutoff value was 19 g sensitivity 800 specificity 839 This study has been approved by the Institutional review board ethics committee and has therefore been performed in accordance with the ethical standards outlined in the 1964 Declaration of Helsinki and its later amendments All persons provided their informed consent prior to their inclusion in the study
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