MP27-17 COULD DETRUSOR OVERACTIVITY PREDICT THE USE OF ANTIMUSCARINICS AFTER MID-URETHRAL SLING IN WOMEN WITH MIXED URINARY INCONTINENCE?

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Incontinence: Evaluation (Urodynamic Testing)1 Apr 2018MP27-17 COULD DETRUSOR OVERACTIVITY PREDICT THE USE OF ANTIMUSCARINICS AFTER MID-URETHRAL SLING IN WOMEN WITH MIXED URINARY INCONTINENCE? Yun-Chu Chang, Yu-Hua Fan, and Alex T.L. Lin Yun-Chu ChangYun-Chu Chang More articles by this author , Yu-Hua FanYu-Hua Fan More articles by this author , and Alex T.L. LinAlex T.L. Lin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.896AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients with mixed urinary incontinence (MUI) suffer from components of both stress urinary incontinence (SUI) and overactive bladder (OAB). Many studies have shown that surgical management of SUI with a mid-urethral sling (MUS) may help OAB symptoms. It is important to evaluate the predictive factors of change in OAB symptoms after MUS in MUI patients. We conduct this study to evaluate whether detrusor overactivity (DO) could predict the change in OAB symptoms after MUS in women with MUI. METHODS We retrospectively recruited female patients with MUI treated with retropubic synthetic MUS between 2008 and 2015. All patients completed the questionnaires of Overactive Bladder Symptoms Score (OABSS) and Urogenital Distress Inventory (UDI-6) preoperatively. MUI was defined as clinical SUI with positive response to urgency or urge incontinence subscale of OABSS, or urge incontinence subscale of UDI-6. All patients underwent videourodynamic study prior to MUS. The primary outcome was the postoperative use of antimuscarinics defined as the prescription of antimuscarinics one month after MUS for more than one month. We evaluated the effects of DO and other potential risk factors for the primary outcome. RESULTS A total of 187 patients were included in the study, with 35 demonstrated with DO and 152 without DO. 26 patients with DO and 110 patients without DO required postoperative antimuscarinics. The mean duration of postoperative antimuscarinics was 6.2 ± 4.1 months. There was no significant difference in postoperative antimiscarinics between patients with and without DO. However, patients with lower detrusor pressure at maximum flow tended to use antimuscarinics after MUS in DO patients. Age, body mass index and the combination of pelvic organ prolapse surgery were similar between patients with and without postoperative antimuscarinics. Urgency and urge incontinence subscores of OABSS were significantly higher in patients with postoperative antimuscarinics than those without. Besides, urgency subscore of UDI-6 was significantly higher in patients requiring postoperative antimuscarinics. CONCLUSIONS DO alone could not predict the use of antimuscarinics after MUS in women with MUI. Nevertheless, DO patients with lower detrusor pressure at maximum flow have the tendency toward using postoperative antimuscarinics. MUI women with more severe baseline urgency and urge incontinence have higher possibility to use antimuscarinics after MUS. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e354 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Yun-Chu Chang More articles by this author Yu-Hua Fan More articles by this author Alex T.L. Lin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...