title: [Usefulness of urodynamics in the treatment of mixed urinary incontinence in women with suburethral slings].
abstract: OBJECTIVE
  The urodynamic results in suburethral slings (SS), are contradictory. We evaluate a series on patients with stress urinary incontinence (associated or not with bladder hyperactivity) that underwent suburethral slings (SS) operations.
  
  
  METHODS
  42 women (age 62±12 years) with urinary incontinence underwent suburethral slings (86% TOT, 12% TVT, 2% others), 36% of them with simultaneous pelvic organ prolapse correction. Medical history and a pre and postsurgery urodynamic studies (according to ICS instructions, except when specified) were performed.
  
  
  RESULTS
  After surgery, the improvement of urinary incontinence was lower in patients with previous detrusor hyperactivity (DH) than without DH (60% vs 81 %), and the bladder capacity (BC) was lower (123±36 ml) in patients with previous mixed urinary incontinence (MUI) versus no MUI (241±83 ml) (p=0.004). The decrease of BC was higher with previous MUI (184±92 ml vs 123±36 ml) versus no MUI (240±91 ml vs 237±78 ml), and the DH was more frequent in previous MUI and DH. There was a significant decrease of maximum flow rate (Qmax) (p=0.000) (although without clinical manifestation), and post void residual urine (p=0.007). We demonstrated a significant increase (p=0.001) of mean urethral resistance (URA): 12±9 cm H2O versus 15±12 cm H2O (without reaching obstruction range), and an improvement of detrusor contractility (W80-20): (3±4 W/m2; vs 6±17 W/m2;).
  
  
  CONCLUSIONS
  We demonstrated worst results in MUI in patients with urinary incontinence undergoing SS. The urodynamic study gives a better prognosis reliability in the treatment of female urinary incontinence with SS.
authors.affiliation: Service of Urology. Hospital Clínico San Carlos. Madrid. Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Salinas-Casado
authors.affiliation: Service of Urology. Hospital Universitario Sanitas La Moraleja. Madrid. Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Méndez-Rubio
authors.affiliation: Service of Urology. Hospital Clínico Universitario. Valladolid. Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Pesquera-Ortega
authors.affiliation: Service of Urology. Hospital Nacional de Parapléjicos. Toledo. Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Vírseda-Chamorro
authors.affiliation: Service of Urology. Hospital General. Talavera de la Reina. Toledo. Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Gutiérrez-Martín
authors.affiliation: Service of Urology. Hospital Clínico San Carlos. Madrid. Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Resel-Folkersma
authors.affiliation: Service of Urology. Hospital Nacional de Parapléjicos. Toledo. Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Esteban-Fuertes
authors.affiliation: Service of Urology. Hospital Clínico San Carlos. Madrid. Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Moreno-Sierra
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D053825:Suburethral Slings; D014550:Urinary Incontinence, Stress / Q000503:physiopathology* / Q000601:surgery*; D014563:Urodynamics; D013520:Urologic Surgical Procedures / Q000379:methods