Preoperative hesitating urinary stream is associated with postoperative voiding dysfunction and surgical failure following Burch colposuspension or pubovaginal rectus fascial sling surgery.
OBJECTIVE
We hypothesized that certain preoperative voiding symptoms would be correlated with poorer post-continence surgery outcomes in women.


METHODS
Preoperative voiding symptoms from 655 women were assessed with questionnaires. Outcomes (overall failures, stress-specific failures, and voiding dysfunction) after Burch or sling surgery were measured. Logistic regression models were used to associate preoperative voiding symptoms with postoperative outcomes.


RESULTS
Hesitating urinary stream was associated with voiding dysfunction [OR 2.22, p=0.01], overall [OR 1.57, p=0.03], and stress-specific [OR 1.67, p=0.009] failures. A ten-point increase in preoperative Urogenital Distress Inventory-obstructive (UDI-O) subscore was associated with overall [OR 1.10, p=0.049] and stress-specific [OR 1.21, p<0.0001] failures. Even controlling for severity of POPQ stage, significant associations of hesitating urinary stream with voiding dysfunction, overall and stress-specific failures remained.


CONCLUSIONS
Preoperative hesitating urinary stream and obstructive voiding symptoms were associated with poorer surgical outcomes. Further studies in this area may be fruitful.
University of Maryland Baltimore, Baltimore, MD, USA.
Tatiana V
TV
Sanses
Linda
L
Brubaker
Yan
Y
Xu
Stephen R
SR
Kraus
Jerry L
JL
Lowder
Gary E
GE
Lemack
Peggy
P
Norton
Heather J
HJ
Litman
Sharon L
SL
Tennstedt
Toby C
TC
Chai
D000328:Adult; D005260:Female; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D056887:Pelvic Organ Prolapse / Q000473:pathology; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D014554:Urination; D014563:Urodynamics / Q000502:physiology*; D013520:Urologic Surgical Procedures; D055815:Young Adult