title: [POP-Q indication points, Aa and Ba, involve in diagnosis and prognosis of occult stress urinary incontinence complicated with pelvic organ prolapse].
abstract: OBJECTIVE
  To investigate the correlation between pelvic organ prolapse quantitation (POP-Q) indication points and the incidence of occult stress urinary incontinence (OSUI) and its impact on prognosis.
  
  
  METHODS
  Retrospective study medical records of 93 patients with pelvic organ prolapse (POP) staged at III-IV, of which underwent pelvic reconstruction operations with Prolift system from Jan. 2007 to Sept. 2012. None of these patients had clinical manifestations of stress urinary incontinence (SUI) before surgery, and in which 44 patients were included in study group (POP complicated with OSUI) because they were identified with OSUI, another 49 patients as control group (simple POP). Follow-up and collecting datas including POP-Q, stress test, urodynamic recordings, incidence of de novo SUI, statistic analyzing by logistic regression and receiver operating characteristic curve (ROC).
  
  
  RESULTS
  (1) The study group had a much higher incidence of 30% (13/44) on de novo SUI than that of control group (4%, 2/49; P < 0.01). (2) Vaginal delivery (OR = 5.327, 95% CI: 1.120-25.347), constipation (OR = 5.789, 95% CI: 1.492-22.459), preoperative OSUI (OR = 13.695, 95% CI: 2.980-62.944), anterior vaginal wall prolapse (OR = 6.115, 95% CI: 1.231-30.379) were identified as dependent risk factors for de novo SUI by logistic regression analysis. (3) For POP patients that complicated with OSUI, we chose a cutoff value of +1.5 cm for Aa point as the threshold to predicting incidence of de novo SUI according to ROC curve, area under the curve (AUC) was 0.889 (P < 0.05), the sensitivity reached 88.9% and specificity was 73.9%. According to ROC curve of Ba point, a cutoff value of +2.5 cm was chosen as the threshold to predicting incidence of de novo SUI post-operation, it had a sensitivity of 66.7% and specificity of 82.6%, AUC was 0.766 (P < 0.05).
  
  
  CONCLUSIONS
  Pre-operative OSUI is a dependent risk factor of de novo SUI for advanced POP patients. Aa and Ba points are correlated with preoperative OSUI, and it is worthy to be considered as a risk predictor on forecasting the incidence of de novo SUI post pelvic reconstruction surgery.
authors: Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors: Cheng
authors: C
authors: Liu
authors: Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors: Wenying
authors: W
authors: Wu
authors: Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors: Qing
authors: Q
authors: Yang
authors: Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors: Ming
authors: M
authors: Hu
authors: Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
authors: Yang
authors: Y
authors: Zhao
authors: Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Email: drhongli7777@gmail.com.
authors: Li
authors: L
authors: Hong
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D056887:Pelvic Organ Prolapse / Q000150:complications*; D011183:Postoperative Complications; D011184:Postoperative Period; D011379:Prognosis; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D053825:Suburethral Slings; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000175:diagnosis* / Q000453:epidemiology; D014563:Urodynamics