Concomitant surgical correction of occult stress urinary incontinence by TOT in patients with pelvic organ prolapse.
OBJECTIVE
To assess the post-operative urinary incontinence states of pelvic organ prolapse cases operated on with concomitant trans-obturator tape (TOT) procedure.


METHODS
Urodynamic evaluation of 79 patients with pelvic organ prolapse, before and after operation, while reducing the prolapsed organs by ring forceps placed bilaterally on the anterolateral sulcuses avoiding urethral compression. According to urodynamic tests, 25 patients were diagnosed as having occult stress urinary incontinence.


RESULTS
Post-operative overactive bladder, stress urinary incontinence and mixed incontinence were found in three (12%), two (8%) and one (4%) patients of the occult stress urinary incontinence group, respectively. The corresponding numbers were six (11%), five (9%) and three (6%) in the continent group. No significant difference was found between the groups in terms of post-operative overactive bladder symptoms, stress urinary incontinence and mixed incontinence (Kruskal-Wallis test, X(2) = 0.52, p = 0.820).


CONCLUSIONS
This retrospective study suggests that a complete pre-operative urodynamic evaluation, including urodynamic tests at the time of POP reduction by placing ring forceps on the anterolateral sulcuses, is an efficient method for the diagnosis of occult symptomatic stress urinary incontinence (SUI). Prospective randomized studies are needed to establish the benefits and the risks of concomitant prophylactic surgery in patients with pelvic organ prolapse.
Karateke
Ates
A
Zeynep Kamil Hospital, İstanbul, Turkey.
Tug
Niyazi
N
Cam
Cetin
C
Selcuk
Selcuk
S
Asoglu
Mehmet Resit
MR
D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000209:etiology* / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000150:complications* / Q000601:surgery; D014563:Urodynamics