Abstract
Objective:In this study, we aimed to evaluate the effect of sacrocolpopexy and retropubic midurethral sling, or transvaginal tape (TVT) procedure, on overactive bladder (OAB) symptoms. Our null hypothesis was that concomitant sacrocolpopexy and TVT exacerbate OAB symptoms.Material and Methods:This is a prospective cohort study. All subjects had apical/anterior prolapse and underwent robotic-assisted sacrocolpopexy and TVT, with or without concomitant hysterectomy. All subjects completed a standardized one-year follow-up between 2009 and 2014. To assess for OAB symptoms, we used the Urogenital Distress Inventory subscale questions #15 and/or question #16. Reponses to these questions are based on a five-point 0 to 4 Likert scale (0 represents a negative response or no symptoms, and 4 represents the most problems). Any patient who answered 1 or higher on the Likert scale, either on the frequency or urge incontinence question, was defined as having OAB symptoms.Results:Sixty-six subjects completed 12 months of visits. Preoperatively, 54 patients (83%) had OAB symptoms, and postoperatively 29 patients (45%) had OAB symptoms (p<0.001). Patients with postoperative OAB had a lower patient global impression of improvement (PGI-I) scores, PGI-I 5.8 with OAB, and PGI-I 6.6 without OAB (p<0.003).Conclusion:We found that sacrocolpopexy and concomitant retropubic midurethral sling does not contribute to additive OAB symptoms, and symptoms actually resolved in 38% of women in our cohort. The presence of postoperative OAB contributes to lower global impression of improvement.
Highlights
Pelvic organ prolapse (POP) and urinary incontinence are common healthcare problems, with one in four adult women in the United States reporting at least one pelvic floor disorder [1]
The primary aim of our study was to evaluate the effect of sacrocolpopexy and transvaginal tape (TVT) on overactive bladder (OAB) symptoms
We found that almost half of the patients with OAB symptoms preoperatively had resolution of symptoms at 12 months after surgery
Summary
Pelvic organ prolapse (POP) and urinary incontinence are common healthcare problems, with one in four adult women in the United States reporting at least one pelvic floor disorder [1]. Hospital- and community-based studies have shown that the prevalence of OAB is higher in women with POP [5, 6]. Presence of OAB symptoms have been reported in up to 88% of women with POP [7]. Several studies have shown improvement in symptoms of OAB after POP surgery [10,11,12,13,14]. The majority of these studies included women who underwent repair in the anterior or apical vaginal compartment. OAB subjectively improves in more than 60% of patients undergoing transvaginal tape (TVT) retropubic midurethral sling
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