MP10-10 DOES THE DEGREE OF CYSTOCELE PREDICT DE-NOVO STRESS URINARY INCONTINENCE AFTER PROLAPSE REPAIR? FURTHER ANALYSIS OF THE CARE TRIAL

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Pelvic Prolapse1 Apr 2016MP10-10 DOES THE DEGREE OF CYSTOCELE PREDICT DE-NOVO STRESS URINARY INCONTINENCE AFTER PROLAPSE REPAIR? FURTHER ANALYSIS OF THE CARE TRIAL Michael Davenport, Eric Sokol, and Christopher Elliott Michael DavenportMichael Davenport More articles by this author , Eric SokolEric Sokol More articles by this author , and Christopher ElliottChristopher Elliott More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2340AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cystoceles may cause urethral obstruction by altering the vesico-urethral angle. Restoration of normal anatomy after vaginal prolapse repair can relieve this urethral “kink”, but may unmask stress incontinence (SUI). The association between the severity of cystocele and developing de-novo SUI after prolapse repair however, is poorly understood. We hypothesized that in women undergoing prolapse repair, increasing degrees of bladder prolapse would be associated with increasing rates of post-operative de-novo SUI. METHODS We performed a secondary analysis of the Colpopexy and Urinary Reduction Efforts (CARE) trial data. Using the control arm (women undergoing prolapse repair without a prophylactic SUI procedure), we identified de-novo SUI using a composite definition based on original trial criteria, including 1) new symptoms of SUI, 2) new physical exam findings of SUI and 3) any treatment for SUI within one year of prolapse repair. We performed logistic regression to evaluate the relationship between the degree of cystocele and the development of new SUI. RESULTS Of the 168 women who underwent abdominal sacrocolpopexy alone, 53% developed de-novo post-operative SUI. Stratifying by the degree of anterior prolapse (point Ba), we found a linear increase in the rate of SUI with worsening preoperative cystocele. The incidence of de-novo SUI based on tertile of anterior prolapse from least to most severe, was 41.7%, 53.3% and 63.3%, respectively (Table 1). Point Ba was found to be significant for predicting de-novo SUI on both univariate (OR=1.17 3, p-value 0.015), and multivariate analysis (OR=1.16, p-value 0.04). CONCLUSIONS The incidence of de-novo SUI after prolapse repair directly correlates to the degree of cystocele on preoperative exam. This simple yet novel relationship should further guide discussions about potential post-operative incontinence with women undergoing prolapse repair. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e105-e106 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Michael Davenport More articles by this author Eric Sokol More articles by this author Christopher Elliott More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...