Abstract
Introduction and hypothesis
To investigate how pelvic organ prolapse (POP) surgery affects symptoms of urinary incontinence (UI) in women with POP and concomitant UI.
Methods
Data from the Danish Urogynaecological Database were collected from 2013 to 2016. Inclusion criteria were urinary incontinent women who underwent POP surgery alone. Based on the preoperative results of the International Consultation on Incontinence Questionnaire–Urinary Incontinence-short form (ICIQ-UI-sf), women were categorized with stress urinary incontinence (SUI), urgency urinary incontinence (UUI) or mixed urinary incontinence (MUI). Postoperatively, the women were categorized based on the postoperative ICIQ-UI-sf, except here, undefined urinary incontinence and urinary continence were added to the categories. Statistical analyses included multivariate logistic regression analyses, examining the odds of urinary continence in each category. The included parameters were preoperative POP stage (POP-Q), compartment, BMI, age and preoperative ICIQ-UI-sf total score. P-values < 0.05 were considered statistically significant.
Results
A total of 1657 women were included. Significantly more women with preoperative UUI achieved urinary continence (60%) compared to women with preoperative SUI (52%) and MUI (38%). More than 70% of all women achieved either urinary continence or an improvement in UI, regardless of subtype. For women with UUI, the likelihood of achieving urinary continence was higher if the anterior compartment was involved. Women with MUI were more likely to achieve urinary continence if they had POP-Q stage 3–4.
Conclusions
Most women with symptomatic POP and concomitant UI find that their UI is either cured or improved after POP surgery alone.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
van der Ploeg J, van der Steen A, Oude Rengerink K, van der Vaart C, Roovers J. Prolapse surgery with or without stress incontinence surgery for pelvic organ prolapse: a systematic review and meta-analysis of randomised trials. BJOG Int J Obstet Gynaecol. 2014;121(5):537–47.
Guldberg R, Brostrøm S, Hansen JK, Kærlev L, Gradel KO, Nørgård BM, et al. The Danish Urogynaecological database: establishment, completeness and validity. Int Urogynecol J. 2013;24(6):983–90.
Mouritsen L, Larsen JP. Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14(2):122–7.
Costantini E, Lazzeri M, Bini V, Del Zingaro M, Frumenzio E, Porena M, et al. Pelvic organ prolapse repair with and without concomitant Burch colposuspension in incontinent women: a randomised controlled trial with at least 5-year Followup, pelvic organ prolapse repair with and without concomitant Burch Colposuspension in incontinent women: a randomised controlled trial with at least 5-year Followup. Obstet Gynecol Int Obstet Gynecol Int. 2011;2012:e967923.
Lensen EJM, Withagen MIJ, Kluivers KB, Milani AL, Vierhout ME. Urinary incontinence after surgery for pelvic organ prolapse. Neurourol Urodyn. 2013;32(5):455–9.
Ugianskiene A, Kjærgaard N, Larsen T, Glavind K. What happens to urinary incontinence after pelvic organ prolapse surgery? Int Urogynecol J. 2019;30(7):1147–52.
Borstad E, Abdelnoor M, Staff AC, Kulseng-Hanssen S. Surgical strategies for women with pelvic organ prolapse and urinary stress incontinence. Int Urogynecol J. 2010;21(2):179–86.
Colombo M, Vitobello D, Proietti F, Milani R. Randomised comparison of Burch colposuspension versus anterior colporrhaphy in women with stress urinary incontinence and anterior vaginal wall prolapse. BJOG Int J Obstet Gynaecol. 2000;107(4):544–51.
van der Ploeg J, Oude Rengerink K, van der Steen A, van Leeuwen J, Stekelenburg J, Bongers M, et al. Transvaginal prolapse repair with or without the addition of a midurethral sling in women with genital prolapse and stress urinary incontinence: a randomised trial. BJOG Int J Obstet Gynaecol. 2015;122(7):1022–30.
Baessler K, Christmann-Schmid C, Maher C, Haya N, Crawford TJ, Brown J. Surgery for women with pelvic organ prolapse with or without stress urinary incontinence. Cochrane Database Syst Rev [Internet]. 2018 Aug 19;2018(8). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513383/
Daneshgari F, Kong W, Swartz M. Complications of mid urethral slings: important outcomes for future clinical trials. J Urol. 2008;180(5):1890–7.
Author information
Authors and Affiliations
Contributions
All authors fulfill the rules of authorship set by the ICMJE.
Y Khayyami: Data collection, Manuscript writing.
M Elmelund: Data collection, Manuscript editing.
N Klarskov: Project development, Manuscript editing.
All authors have given their final approval of the version submitted for publication. All authors are responsible for the entire work.
Corresponding author
Ethics declarations
Conflicts of interest
Yasmine Khayyami has no disclosures. Marlene Elmelund has received paid travel expenses and honoraria from Contura outside the submitted work. Niels Klarskov has received paid travel expenses from Contura outside the submitted work.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Khayyami, Y., Elmelund, M. & Klarskov, N. Urinary incontinence before and after pelvic organ prolapse surgery—A national database study. Int Urogynecol J 32, 2119–2123 (2021). https://doi.org/10.1007/s00192-021-04738-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-021-04738-6