Abdominal sacrocolpopexy and urinary incontinence: surgical planning based on urodynamics

Denise M Elser, Michael D Moen, Edward J Stanford, Kristinell Keil, Catherine A Matthews, Neeraj Kohli, Fleming Mattox, Janet Tomezsko
American Journal of Obstetrics and Gynecology 2010, 202 (4): 375.e1-5

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.

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