Does previous pelvic surgery hasten the onset of clinically bothersome urodynamic stress incontinence?

Abstract

ObjectiveTo study the impact of previous pelvic surgery on the onset of clinically bothersome urodynamic stress incontinence (USI). Study designRetrospective case-cohort study at a District General Hospital of 305 women undergoing surgery for urodynamic stress incontinence: case note and computer records review of patients undergoing USI surgery. The main outcome measures were age at index USI surgery, and duration from previous pelvic surgery to index surgery. Results305 women were included, of whom 118 had previous pelvic surgery including abdominal hysterectomy (TAH) (n=74), vaginal hysterectomy (n=23), anterior colporrhaphy (n=27) and posterior colporrhaphy (n=25). The mean age in the previous surgery group was 62.4 years (95% CI 60.2–64.6, range 32–87) and 53.2 years in the no previous surgery group (95% CI 51.4–55, range 30–88). There were no differences in the mean BMI (28.4 vs. 27.5), or mean parity (2.4 vs. 2.5). The median duration from previous surgery to the index USI surgery was 222 months (abdominal hysterectomy), 96 months (vaginal hysterectomy), 78 months (anterior colporrhaphy), and 72 months (posterior colporrhaphy). ConclusionPrevious pelvic surgery does not seem to accelerate the onset of USI, as women without previous pelvic surgery presented at a significantly earlier age (53.2 years) with clinically bothersome USI than those who had previous surgery (62.4 years). Posterior colporrhaphy had the shortest interval to index USI surgery amongst previous operations.