title: A prospective observational study of lower urinary tract symptoms before and after surgical removal of a large pelvic mass.
abstract: OBJECTIVE
  The aim of this study was to assess the impact of the surgical removal of a large pelvic mass on preexisting lower urinary tract symptoms (LUTS) and function.
  
  
  METHODS
  This was a prospective study of planned surgical management of women with a large pelvic mass (uterine or ovarian mass ≥ 7 cm on pelvic ultrasound) who also reported bothersome LUTS (urinary frequency, urgency, incontinence and/or voiding dysfunction). Assessment included structured history and examination, completion of the short forms of the Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7), a 3-day bladder diary and multi-channel urodynamics (UDS) at baseline and 3 months postoperatively. The primary outcome was a reduction in the total mean scores of the UDI-6 and IIQ-7. Secondary outcomes were a change in bladder diary and UDS parameters. Univariate analysis and paired t test were used in the statistical analysis.
  
  
  RESULTS
  Twenty-nine women underwent surgical management of a pelvic mass. The most common preoperative urinary symptom was urinary urgency. Two women had overt urinary retention that resolved completely postoperatively. All women completed pre- and postoperative UDI-6 and IIQ-7. The UDI-6 and IIQ-7 demonstrated a highly significant reduction in the mean total scores of 66%, signifying symptom and quality of life improvement. Bladder diary parameters showed significant reductions in daytime urinary frequency and stress incontinence episodes. Maximum and average voided volumes increased by a mean of 60 ml. Only 14 women underwent postoperative UDS.
  
  
  CONCLUSIONS
  This study provides evidence that the majority of LUTS present preoperatively improve significantly or resolve completely following removal of a ≥ 7-cm pelvic mass.
authors.affiliation: Mercy Hospital for Women, 163 Studley Road, Heidelberg, Melbourne, Victoria, 3084, Australia, kcvach@gmail.com.
authors.forename: Kristina
authors.initials: K
authors.lastname: Cvach
authors.forename: Peter
authors.initials: P
authors.lastname: Dwyer
authors.forename: Anna
authors.initials: A
authors.lastname: Rosamilia
authors.forename: Yik
authors.initials: Y
authors.lastname: Lim
authors.forename: Lore
authors.initials: L
authors.lastname: Schierlitz
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D059411:Lower Urinary Tract Symptoms / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D010048:Ovarian Cysts / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000150:complications / Q000601:surgery*; D014594:Uterine Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*