Urodynamic predictors of de novo overactive bladder after single-incision sling.

Abstract

Listen

Translate article

To identify urodynamic predictors for de novo overactive bladder (OAB) after single-incision sling implantation. This retrospective study analyzed women with pure, urodynamically proven stress urinary incontinence, without OAB, between 2008 and 2015, in a university hospital. De novo OAB was investigated during clinical interviews. A total of 192 patients were analyzed; 21 patients with de novo OAB were considered as group A while 171 control patients formed group B. Univariate analysis demonstrated that patients with de novo OAB have the first desire to void at a lower bladder volume (124mL versus 160mL, P=0.0052), smaller maximum cystometric capacity (357mL versus 406mL, P=0.0061), lower maximum flow (17mL/s versus 23mL/s, P=0.0006), and higher bladder outlet obstruction index (BOOI; -11 versus -23, P=0.0022) compared with controls. According to multivariate analysis, maximum cystometric capacity (parameter estimate [PE]=0.008, P=0.04) and BOOI (PE=-0.029, P=0.01) were independent urodynamic predictors of de novo OAB. The final model showed good predictive accuracy (area under the curve=0.81). The present study identified maximum cystometric capacity and BOOI as independent predictors of de novo overactive bladder after single-incision sling implantation. Therefore, preoperative urodynamics may be useful to improve preoperative counseling and to tailor surgical treatment.