title: The effect of pelvic organ prolapse severity on improvement in overactive bladder symptoms after pelvic reconstructive surgery.
abstract: OBJECTIVE
  This study evaluates the effect of baseline pelvic organ prolapse (POP) severity on improvement in overactive bladder (OAB) symptoms after pelvic reconstructive surgery.
  
  
  METHODS
  We performed a retrospective cohort study of women with POP and OAB who underwent surgical correction of symptomatic apical and/or anterior POP. OAB was defined as an affirmative response to item #15 (urinary frequency) and/or item #16 (urge incontinence) of the Pelvic Floor Distress Inventory (PFDI). POP severity was dichotomized as Pelvic Organ Prolapse Quantification (POP-Q) stage 1-2 versus stage 3-4. Our primary outcome was complete resolution or improvement of urinary frequency or urge incontinence on the PFDI 12 months postoperatively.
  
  
  RESULTS
  At 12 months postoperative, 41 (89%) women with stage 1-2 POP versus 47 (85 %) with stage 3-4 POP reported improvement in urinary frequency (p = 0.58). Thirty five (90 %) with stage 1-2 and 34 (85 %) with stage 3-4 POP reported improvement in urge incontinence (p = 0.74). On multiple logistic regression, women with stage 3-4 POP had a decreased odds of improvement in frequency or urge incontinence compared with women with stage 1-2 POP (adjusted odds ration [AOR] = 0.06 [95 % CI 0.01-0.67]), after adjusting for confounders.
  
  
  CONCLUSIONS
  Women with coexisting POP and OAB who undergo surgical correction of POP experience improvement in OAB symptoms after surgery, although women with more severe POP may be at a higher risk of persistent frequency or urge incontinence.
authors.affiliation: Medstar Washington Hospital Center/Georgetown University School of Medicine, Washington, DC 20010, USA. Jeannine.M.Miranne@medstar.net
authors.forename: Jeannine M
authors.initials: JM
authors.lastname: Miranne
authors.forename: Vrishali
authors.initials: V
authors.lastname: Lopes
authors.forename: Cassandra L
authors.initials: CL
authors.lastname: Carberry
authors.forename: Vivian W
authors.initials: VW
authors.lastname: Sung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery*; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000601:surgery*; D015995:Prevalence; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000453:epidemiology* / Q000601:surgery*; D053202:Urinary Incontinence, Urge / Q000453:epidemiology / Q000517:prevention & control