title: The ability of history and a negative cough stress test to detect occult stress incontinence in patients undergoing surgical repair of advanced pelvic organ prolapse.
abstract: To determine if a negative preoperative reduction cough stress test is a viable method of detecting occult stress incontinence or urge incontinence in women undergoing surgical repair of advanced pelvic organ prolapse. A retrospective chart review was done on all patients who denied any urinary complaints and had repair of advanced pelvic organ prolapse, grade two or greater, without the addition of an anti-incontinence procedure. Additionally patients had a simple office filling study done at the time of initial examination that failed to show the sign of stress incontinence or detrusor instability. Any urinary dysfunction that developed postoperatively was noted. A total of 53 patients met the inclusion criteria. Of these patients, one patient (1.9%) developed genuine stress incontinence, and one patient complained of urgency (1.9%). Patients without urinary complaints and a negative office filling study, who were present for surgical correction of advanced pelvic organ prolapse, have a low incidence of developing occult stress incontinence. Further work-up would not be cost effective.
authors.affiliation: Department of Obstetrics and Gynecology Division of Urogynecology and Pelvic Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH, USA. aprylle_corbin@trihealth.com
authors.forename: Steven
authors.initials: S
authors.lastname: Kleeman
authors.forename: Brett
authors.initials: B
authors.lastname: Vassallo
authors.forename: Jeffery
authors.initials: J
authors.lastname: Segal
authors.forename: Melanie
authors.initials: M
authors.lastname: Hungler
authors.forename: Mickey
authors.initials: M
authors.lastname: Karram
mesh_terms: D015897:Comorbidity; D003371:Cough / Q000453:epidemiology; D005260:Female; D006547:Hernia / Q000453:epidemiology; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology; D020047:Rectocele / Q000453:epidemiology; D012189:Retrospective Studies; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000453:epidemiology; D014596:Uterine Prolapse / Q000453:epidemiology / Q000601:surgery*