PD33-03 IMPACT OF FEMALE STRESS URINARY INCONTINENCE SURGERY ON PRE-OP OVERACTIVE BLADDER SYMPTOMS

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology I1 Apr 2014PD33-03 IMPACT OF FEMALE STRESS URINARY INCONTINENCE SURGERY ON PRE-OP OVERACTIVE BLADDER SYMPTOMS Halina Zyczynski, Michael Albo, Hae-Young Kim, Maude Carmel, Clifford Wai, Peggy Norton, Linda Brubaker, Larry Sirls, R.E. Varner, Howard Goldman, and Urinary Incontinence Treatment Network Halina ZyczynskiHalina Zyczynski More articles by this author , Michael AlboMichael Albo More articles by this author , Hae-Young KimHae-Young Kim More articles by this author , Maude CarmelMaude Carmel More articles by this author , Clifford WaiClifford Wai More articles by this author , Peggy NortonPeggy Norton More articles by this author , Linda BrubakerLinda Brubaker More articles by this author , Larry SirlsLarry Sirls More articles by this author , R.E. VarnerR.E. Varner More articles by this author , Howard GoldmanHoward Goldman More articles by this author , and Urinary Incontinence Treatment Network More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2286AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Persistence of overactive bladder (OAB) symptoms decreases satisfaction with stress urinary incontinence (SUI) surgery. We assessed the impact of SUI surgery on OAB symptoms up to 5 years post-op and identified predictors of OAB symptom change. METHODS We analyzed data from 2 multicenter SUI surgical trials of women with stress predominant mixed urinary incontinence conducted by the UITN: SISTEr (Burch v. autologous fascial sling) and TOMUS (retropubic v. transobturator midurethral sling). The primary outcome was improvement of ≥70% from baseline in symptoms measured by irritative subscale of the Urinary Distress Inventory (UDI-I) and MESA Urge Index. Differences in procedure outcomes were compared within the trial. Regression models used 12 and 60 month data. RESULTS At 12 months, most women (60-76%) reported OAB symptom improvement (Figure 1). Symptom improvement was similar between TOMUS sling groups at 1 year(70.3% RMUS vs 72.9% TMUS, p=0.70) and 5 years. More women reported symptom improvement in the Burch group compared to the sling (71% vs 59.6%, p=0.01) at 1 year; this difference was sustained at 5 years. Similar, significant improvements from baseline urgency incontinence were observed for each group in SISTEr and TOMUS without significant group differences. The % of women with symptom improvement declined significantly in each group, though at 5 years, 49%-67% continued to report improvement. Predictors of symptom change in TOMUS included concomitant surgery (decreased odds of improvement at 12 months) and greater baseline symptom severity (increased odds of improvement). Variables not predictive of symptom change included pre-operative anticholinergics, urodynamic detrusor overactivity, bladder volumes at first desire, strong desire or maximum cystometric capacity. Greater symptom improvement at 12 months occurred in SISTEr participants who were menopausal(on HRT), who were not obese, and with greater baseline OAB symptoms; conversely, increasing parity reduced the odds of symptom improvement. CONCLUSIONS Most women with stress predominant mixed urinary incontinence experienced significant improvement in OAB wet and dry symptoms after SUI surgery although initial improvement diminishes over time. Urodynamic parameters are not prognostic of change in baseline OAB symptoms. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e841-e842 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Halina Zyczynski More articles by this author Michael Albo More articles by this author Hae-Young Kim More articles by this author Maude Carmel More articles by this author Clifford Wai More articles by this author Peggy Norton More articles by this author Linda Brubaker More articles by this author Larry Sirls More articles by this author R.E. Varner More articles by this author Howard Goldman More articles by this author Urinary Incontinence Treatment Network More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...