title: Urogenital prolapse and occult stress urinary incontinence.
abstract: BACKGROUND
  A 76-year-old female presented to an outside clinic with symptoms of pelvic prolapse; she denied stress urinary incontinence (SUI). The patient had a history of two prior anti-incontinence surgeries. Pelvic examination revealed a grade IV cystocele. No SUI was identified, with or without reduction of the prolapse. Anterior colporrhaphy with cadaveric fascia was performed. Her prolapse symptoms resolved, but she had new-onset severe SUI.
  
  
  METHODS
  Pelvic examination, cystoscopy, urodynamics. DIAGNOSIS OCCULT: SUI unmasked after anterior colporrhaphy.
  
  
  RESULTS
  The patient was referred to our institution where videourodynamics were performed, revealing a well-supported bladder and SUI with Valsalva leak-point pressure of 26 cm H20. A transvaginal polypropylene sling was placed. She had complete resolution of SUI and denied exacerbation of mild urgency.
authors.affiliation: Continence Center at Virginia Mason, Seattle, WA 98111, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Yamada
authors.forename: Kathleen C
authors.initials: KC
authors.lastname: Kobashi
mesh_terms: D000368:Aged; D052858:Cystocele / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D014550:Urinary Incontinence, Stress / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery; D014596:Uterine Prolapse / Q000150:complications* / Q000175:diagnosis* / Q000601:surgery