title: Is Occult Stress Urinary Incontinence a Reliable Predictive Marker?
abstract: Pelvic reconstructive surgery can be associated to correction, persistence, or onset of stress urinary incontinence. The aim of our study was to evaluate the incidence of stress incontinence (SI) after prolapse repair in 3 groups with different preoperative urodynamic findings and to find out the predictiveness of occult SI.
  
  
  
  Patients undergoing vaginal hysterectomy, uterus-sacral ligament colposuspension, and traditional anterior repair for pelvic prolapse were retrospectively analyzed. No patient underwent any additional anti-incontinence procedure. Preoperative evaluation included clinical history, physical examination, and urodynamic assessment with a pessary reduction test. According to urodynamic findings, women were divided into SI (A), occult SI (B), and continence (C) groups. Primary outcome was to compare the incidence of postoperative SI among groups. Secondary outcome was to assess postoperative quality of life with International Consultation on Incontinence questionnaire-short form questionnaire.
  
  
  
  One hundred fifty patients were analyzed (A: n = 30; B: n = 43; C: n = 77). Mean follow-up was 18.4 ± 0.9 months without differences among groups. Patients in group B did not have higher postoperative SI rate compared to group C. There were no differences in International Consultation on Incontinence questionnaire-short form scores in symptomatic women among groups.
  
  
  
  In our series, occult stress urinary incontinence is a poor urodynamic marker to predict the development of postoperative SI.
authors.affiliation: From the *Department of Obstetrics and Gynecology, San Gerardo Hospital; and †School of Medicine, University of Milano-Bicocca, Monza, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Manodoro
authors.forename: Federico
authors.initials: F
authors.lastname: Spelzini
authors.forename: Matteo
authors.initials: M
authors.lastname: Frigerio
authors.forename: Elena
authors.initials: E
authors.lastname: Nicoli
authors.forename: Debora
authors.initials: D
authors.lastname: Verri
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Milani
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000009:adverse effects* / Q000379:methods; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications; D011300:Preoperative Care; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014550:Urinary Incontinence, Stress / Q000209:etiology*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000009:adverse effects*