title: Predictors for detrusor overactivity following extensive vaginal pelvic reconstructive surgery.
abstract: This study aims to identify the predictors for detrusor overactivity (DO) in women following extensive vaginal pelvic reconstructive surgery (PRS) for advanced pelvic organ prolapse (POP).
  
  
  
  We enrolled 1503 women who had prolapse POP-Q stage ≥ 3 and underwent vaginal PRS with or without MUS from January 2006 to December 2015. All subjects completed a 72-h voiding diary, IIQ-7, UDI-6, POPDI-6, and PISQ-12. Urodynamics (UDS) was performed pre- and post-operatively.
  
  
  
  Among 1503 women, 56 patients were excluded due to incomplete data. Women who had trans-vaginal mesh were 1083 of 1447 (74.8%) and concomitant MUS were 353 (24.4%). Pre-operative DO were 245 (16.9%) and 24.5% (60/245) of them continued to have persistent DO post-operatively. Women who had normal pre-operative stable detrusor were 1202 (83.1%) and 3.5% (30/1202) developed de novo DO post-operatively. The overall incidence of post-operative DO was 6.2% (90/1447). Patients with age ≥66 year, neurological factors like Cerebrovascular accident and Parkinsonian disease, pre-operative bladder outlet obstruction (BOO) maximum urethral closure pressure (MUCP) ≥60 cmH2O, Maximum flow rate (MFR) <15 mL/s and detrusor at maximum flow (Dmax) ≥20 cmH2O) and post-void residue (PVR) ≥200 mL hold a significant higher risk of developing DO either persistent or de novo following PRS.
  
  
  
  Age ≥66 year, neurological factors like CVA and Parkinsonian disease, pre-operative MUCP ≥60 cmH2O, MFR < 15 mL, Dmax ≥ 20 cmH2O, and PVR ≥ 200 mL are independent risk factors for developing post-operative DO following vaginal PRS for advanced POP.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, Taiwan, People's Republic of China.|Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, People's Republic of China.|Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Xiamen Medical Center, Xiamen, People's Republic of China.|Chang Gung University, School of Medicine, Taoyuan, Taiwan, People's Republic of China.
authors.forename: Tsia-Shu
authors.identifier: 0000-0002-3885-1359
authors.initials: TS
authors.lastname: Lo
authors.affiliation: Department of Obstetrics and Gynaecology, Peoples Education Society Medical College and Research Centre, Kuppam, Andhra Pradesh, India.|Fellow, Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, People's Republic of China.
authors.forename: Shailaja
authors.initials: S
authors.lastname: Nagashu
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, People's Republic of China.
authors.forename: Wu-Chiao
authors.initials: WC
authors.lastname: Hsieh
authors.affiliation: Fellow, Division of Urogynaecology, Department of Obstetrics and Gynaecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, People's Republic of China.|Department of Obstetrics and Gynecology, Dr. Pablo O. Torre Memorial Hospital, Bacolod City, Philippines.
authors.forename: Ma Clarissa
authors.initials: MC
authors.lastname: Uy-Patrimonio
authors.affiliation: Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, People's Republic of China.
authors.forename: Lin
authors.initials: L
authors.lastname: Yi-Hao
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D064266:Preexisting Condition Coverage; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012307:Risk Factors; D053201:Urinary Bladder, Overactive / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D014563:Urodynamics; D055815:Young Adult
keywords: bladder outlet obstruction; detrusor at maximum flow; detrusor overactivity; overactive bladder (OAB); post-void residue (PVR)