title: Risk factors for urgency incontinence in women undergoing stress urinary incontinence surgery.
abstract: Objective. To determine baseline variables associated with urgency urinary incontinence (UUI) in women presenting for stress urinary incontinence (SUI) surgery. Methods. Baseline data from two randomized trials enrolling 1,252 women were analyzed: SISTEr (fascial sling versus Burch colposuspension) and TOMUS (retropubic versus transobturator midurethral sling). Demographic data, POP-Q measures, and validated measures of symptom severity and quality of life were collected. Charlson Comorbidity Index (CCI) and Patient Health Questionnaire-9 were measured in TOMUS. Multivariate models were constructed with UUI and symptom severity as outcomes. Results. Over two-thirds of subjects reported bothersome UUI at baseline. TOMUS patients with more comorbidities had higher UDI irritative scores (CCI score 0 = 39.4, CCI score 1 = 42.1, and CCI score 2+ = 51.0, P = 0.0003), and higher depression scores were associated with more severe UUI. Smoking, parity, prior incontinence surgery/treatment, prolapse stage, and incontinence episode frequency were not independently associated with UUI. Conclusions. There were no modifiable risk factors identified for patient-reported UUI in women presenting for SUI surgery. However, the direct relationships between comorbidity level, depression, and worsening of UUI/urgency symptoms may represent targets for preoperative intervention. Further research is necessary to elucidate the pathophysiologic mechanisms that explain the associations between these medical conditions and bladder function.
authors.affiliation: Departments of Urology and Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, Female Pelvic Medicine & Reconstructive Surgery, Yale-New Haven Hospital, Yale University, 310 Cedar Street, FMB 329E, New Haven, CT 06519, USA.
authors.forename: Leslie M
authors.initials: LM
authors.lastname: Rickey
authors.forename: Liyuan
authors.initials: L
authors.lastname: Huang
authors.forename: David D
authors.initials: DD
authors.lastname: Rahn
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Hsu
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Litman
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Mueller