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Bladder neck incompetence could be an etiology of overactive bladder syndrome in women with stress urinary incontinence after anti-incontinence surgery: insights from transrectal sonography

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Abstract

Purpose

To investigate the prevalence of bladder neck incompetence (BNI) and the anatomic differences between different types of urinary incontinence (UI) and overactive bladder (OAB) by transrectal sonography, and to investigate these differences among those with stress UI (SUI) or mixed UI (MUI) who exhibited de novo or persistent OAB symptoms following anti-incontinence surgery.

Methods

A retrospective analysis was conducted on a total of 184 patients with SUI, MUI, urge UI (UUI), or OAB dry who underwent transrectal ultrasound between 2017 and 2022. The presence of BNI and urethral incompetence assessed by transrectal ultrasound were recorded in all included patients, and recorded preoperatively and postoperatively among patients with SUI and MUI who underwent anti-incontinence surgery.

Results

Among the patients, 91%, 84%, 76%, and 71% exhibited BNI in MUI, SUI, UUI, OAB dry group, respectively. Significantly higher rate of patients with BNI were found in MUI than in OAB dry group. Patients with OAB symptoms after anti-incontinence surgery exhibited significantly higher rates of BNI and urethral incompetence than those who did not have postoperative OAB symptoms. Among MUI patients with preoperative BNI, significantly lower rate of postoperative BNI and urethral incompetence was observed in individuals who had improved OAB symptoms after surgery, compared to those without improvement.

Conclusion

A higher BNI rate was observed in the MUI group. A significantly higher BNI rate was observed in women with OAB symptoms after anti-incontinence surgery. Patients with MUI had improved OAB symptoms if BNI was successfully corrected after anti-incontinence surgery.

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Data availability statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors appreciate the generous support from the Kaohsiung Medical University Hospital at Kaohsiung Medical University and Kaohsiung Medical University Regenerative Medicine and Cell Therapy Research Center.

Funding

This research was funded partly by Kaohsiung Medical University Chung-Ho Memorial Hospital (Grant number: KMUH-111-1M48).

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Authors and Affiliations

  1. Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Yu-Chen Chen & Hao-Wei Chen

  2. Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Yu-Chen Chen & Hao-Wei Chen

  3. Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan

    Yu-Chen Chen

  4. Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan

    Hao-Wei Chen

  5. Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, No.707 Sec.3, Zhongyang Rd., Hualien City, 970473, Taiwan, ROC

    Hann-Chorng Kuo

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  1. Yu-Chen Chen
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  2. Hao-Wei Chen
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Contributions

Y-CC: conceptualization, data curation, data interpretation, writing—original draft preparation; H-WC: data analysis, statistical analysis, administrative, technical and material support; H-CK: critical revision of the manuscript, supervision, writing—reviewing and editing. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Hann-Chorng Kuo.

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Conflict of interest

The authors declare no conflict of interest for this research.

Ethical approval

This study was approved by the Research Ethics Committee of the Buddhist Tzu Chi General Hospital.

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The manuscript does not contain any individual personal data in any form. All authors reviewed and approved the final version of the manuscript.

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Chen, YC., Chen, HW. & Kuo, HC. Bladder neck incompetence could be an etiology of overactive bladder syndrome in women with stress urinary incontinence after anti-incontinence surgery: insights from transrectal sonography. World J Urol 41, 3083–3089 (2023). https://doi.org/10.1007/s00345-023-04639-x

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  • DOI: https://doi.org/10.1007/s00345-023-04639-x

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