Stress urinary incontinence after vaginal prolapse repair: development and internal validation of a prediction model with and without the stress test

• Published in: Neurourology and urodynamics 2019-04, Vol.38 (4), p.1086-1092
• Main Authors: Ploeg, J. Marinus, Steyerberg, Ewout W., Zwolsman, Sandra E., Vaart, C. Huub, Roovers, Jan‐Paul W.R.
• Format: Article
• Language: English
• Subjects: Aged; Clinical trials; Female; Gynecologic Surgical Procedures - adverse effects; Humans; Middle Aged; Models, Theoretical; pelvic organ prolapse; Pelvic Organ Prolapse - surgery; Postoperative Complications - etiology; prediction model; Prediction models; stress test; stress urinary incontinence; Suburethral Slings - adverse effects; Surgery; Urinary incontinence; Urinary Incontinence, Stress - etiology; Uterine Prolapse - surgery; Vagina; Vagina - surgery
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.23958

Objective To develop a prediction model for stress urinary incontinence (SUI) after vaginal prolapse repair (postoperative stress urinary incontinence [POSUI]) and assess the value of a preoperative stress test. Patients and methods Secondary analysis of two trials in which women were randomised for prolapse repair with or without a midurethral sling (MUS). The trials included women with (CUPIDO‐1, n = 134) and without (CUPIDO‐2, n = 225) coexisting SUI. POSUI was defined as bothersome SUI one year after surgery and/or treatment of SUI in the first postoperative year. Logistic regression analysis was used to define a reference model, which was extended with the preoperative stress test. The stress test was performed with and without reduction of the prolapse. Missing values were imputed 20 times, with bootstrap resampling for internal validation of discriminatory ability. Results Three hundred fifty‐six women could be included. POSUI occurred in 17% of the women (n = 61). The reference model included age (