The significance of prior anti-incontinence surgery in women who present with urinary incontinence.
In a series of 148 consecutive female patients with urinary incontinence 62 (group 1) had undergone 1 or more prior anti-incontinence operations and 86 (group 2) had none. After clinical and urodynamic assessment the incidence of detrusor instability in the 2 groups (44 and 51 per cent) was not significantly different but the incidence of stress incontinence in group 1 was significantly greater than in group 2 (58 and 38 per cent, p less than 0.05). Of the 69 patients with a final diagnosis of stress urinary incontinence 45 (24 in group 1) had surgery and were followed for a mean of 17 months postoperatively. Of the patients 43 (95 per cent) were cured or improved. A total of 17 patients (71 per cent) in group 1 and 3 (17 per cent) in group 2 had a fascial sling. Eight patients had symptomatic postoperative detrusor instability and all had a fascial sling. There also was a significant decrease in postoperative peak flow rate (p less than 0.01) in these patients. Neither the number of previous operations nor the presence of preoperative detrusor instability had a significant effect on the incidence of postoperative detrusor instability.
Awad
S A
SA
Department of Urology, Victoria General Hospital, Halifax, Nova Scotia, Canada.
Flood
H D
HD
Acker
K L
KL
D005260:Female; D006801:Humans; D008722:Methods; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics