title: Urodynamic prediction of occult stress urinary incontinence before vaginal surgery for advanced pelvic organ prolapse: evaluation of postoperative outcomes.
abstract: OBJECTIVE
  : To evaluate the use of urodynamics for assessment of occult stress urinary incontinence (SUI) in women undergoing vaginal surgery for advanced pelvic organ prolapse (POP).
  
  
  METHODS
  : Retrospective chart review of women who underwent vaginal surgery for advanced POP at the University of Rochester Medical Center.
  
  
  RESULTS
  : The study sample was composed of 41 women (mean age: 65.6 years; range: 42-88 years). Prolapse was stage 3 or 4 in 40 (97.6%) women. Urodynamics identified 17 (41.5%) women with occult SUI. Postoperatively, 3 (7.3%) women reported urinary incontinence: 1 with stress and 2 with urge-related symptoms. The woman with postoperative SUI had been diagnosed with occult SUI, but declined continence repair. None of the women without occult SUI on urodynamics reported postoperative SUI.
  
  
  CONCLUSIONS
  : Urodynamic evaluation prior to vaginal surgery for advanced POP can identify women at risk for SUI, who may benefit from concomitant continence repair.
authors.affiliation: From the Departments of *Obstetrics and Gynecology, and †Urology, University of Rochester Medical Center, Rochester, NY.
authors.forename: Erin E
authors.initials: EE
authors.lastname: Duecy
authors.forename: James Q
authors.initials: JQ
authors.lastname: Pulvino
authors.forename: Anna R
authors.initials: AR
authors.lastname: McNanley
authors.forename: Gunhilde M
authors.initials: GM
authors.lastname: Buchsbaum