Urogenital prolapse and occult stress urinary incontinence.
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.
Yamada
Brian S
BS
Continence Center at Virginia Mason, Seattle, WA 98111, USA.
Kobashi
Kathleen C
KC
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