Abdominal sacrocolpopexy and urinary incontinence: surgical planning based on urodynamics

• Published in: American journal of obstetrics and gynecology 2010-04, Vol.202 (4), p.375.e1-375.e5
• Main Authors: Elser, Denise M., MD, Moen, Michael D., MD, Stanford, Edward J., MD, Keil, Kristinell, MD, Matthews, Catherine A., MD, Kohli, Neeraj, MD, Mattox, Fleming, MD, Tomezsko, Janet, MD
• Format: Article
• Language: English
• Subjects: Abdomen; abdominal sacrocolpopexy; Adult; Aged; Aged, 80 and over; Burch urethropexy; Female; Follow-Up Studies; Humans; Middle Aged; midurethral sling; Obstetrics and Gynecology; Pelvic Organ Prolapse - complications; Pelvic Organ Prolapse - physiopathology; Pelvic Organ Prolapse - surgery; Retrospective Studies; Sacrococcygeal Region; stress incontinence; Urinary Bladder - physiology; Urinary Incontinence, Stress - etiology; Urinary Incontinence, Stress - physiopathology; Urinary Incontinence, Stress - surgery; Urodynamics; Urologic Surgical Procedures - methods
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2009.06.022

Objective The objective of the study was to evaluate the use of urodynamics to determine the need for incontinence surgery at the time of abdominal sacrocolpopexy (ASC). Study Design The records of 441 women undergoing ASC during 2005-2007 were reviewed. Group 1 consisted of 204 women (46.3%) with urodynamic stress incontinence (USI), including occult USI, who underwent incontinence surgery with ASC. Group 2 consisted of 237 women (53.7%) without USI who underwent ASC alone. Primary outcome measures were any complaint of postoperative incontinence (stress or urge) or new-onset urgency/frequency (UF). Results At a mean follow-up of 46.6 weeks, the overall rate of incontinence was low and similar for both groups (13.4% in group 1 and 13.3% in group 2 [ P = .967]), as was new-onset UF: 18.6% in group 1 and 11.5% in group 2 ( P = .195). Conclusion Urodynamic evaluation appears to be useful in determining the need for incontinence surgery at the time of ASC.