title: Occult incontinence as predictor for postoperative stress urinary incontinence following pelvic organ prolapse surgery.
abstract: OBJECTIVE
  Recommending prophylactic anti-incontinence procedures to continent women undergoing surgery for pelvic organ prolapse (POP) is controversial. We hypothesized that testing for occult incontinence before surgery using four different tests and three defined test combinations would identify individual women at risk for postoperative stress urinary incontinence (POSUI). The diagnostic accuracy of these tests and test combinations were evaluated.
  
  
  METHODS
  We tested 137 women before and after surgery. Fisher's exact test was used when evaluating associations between test results and outcomes. The validity of each test and test combinations was calculated.
  
  
  RESULTS
  We found a statistically significant association between occult incontinence and POSUI in two tests and all test combinations. However, all tests and test combinations displayed poor performance when predicting at individual levels.
  
  
  CONCLUSIONS
  This study confirms a positive association between occult incontinence and POSUI. Occult incontinence does not, however, adequately identify individual women in need of prophylactic anti-incontinence surgery when undergoing POP repair.
authors.affiliation: Department of Gynaecology, Oslo University Hospital, Ulleval, PB 4956, Nydalen, 0424 Oslo, Norway. Rune.Svenningsen@ous-hf.no
authors.forename: Rune
authors.initials: R
authors.lastname: Svenningsen
authors.forename: Ellen
authors.initials: E
authors.lastname: Borstad
authors.forename: Anny Elisabeth
authors.initials: AE
authors.lastname: Spydslaug
authors.forename: Leiv
authors.initials: L
authors.lastname: Sandvik
authors.forename: Anne Cathrine
authors.initials: AC
authors.lastname: Staff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000209:etiology*