Outcomes of urodynamic mixed urinary incontinence and urodynamic stress incontinence with urgency after mid-urethral sling surgery. 2020

Tsia-Shu Lo, and Yiap Loong Tan, and Leng Boi Pue, and Sandy Chua, and Ming-Ping Wu, and Wu-Chiao Hsieh
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Medical Center, Keelung, Taiwan, Republic of China. 2378@cgmh.org.tw.

Mixed urinary incontinence (MUI) is defined as symptomatic complaint of involuntary leakage associated with urgency and also with exertion, effort, sneezing or coughing. The paucity of research, especially on the surgical management of MUI, limits its best management. This is a retrospective study to determine the outcomes of mixed urinary incontinence after mid-urethral sling surgery with two groups, urodynamic stress incontinence (USI) with urgency and urodynamic mixed urinary incontinence (MUI-UD; USI and detrusor overactivity [DO]). Ninety women (USI + urgency group) with preoperative USI and urgency and no demonstrable DO/DOI attained an objective cure of 82.2%, whereas the remaining 67 (MUI-UD group) women with both USI and DO/DOI were reported to have an objective cure of only 55.2%. Subjective cures were 81.1% and 53.7% respectively. The type of incontinence surgery does not affect postoperative outcomes in either of the groups. Demographic factors identified to have a significant negative effect on cure rates were postmenopausal status (p = 0.005), prior hysterectomy (p = 0.028), pre-operative smaller blafdder capacity (p = 0.001), and a larger volume of pre-operative pad test (p = 0.028). A lower mid-urethral closure pressure (MUCP) was significant with post-operative failure of treatment with MUI-UD group (68.8 ± 36.2 cmH2O vs 51.9 ± 24.7 cmH2O; p = 0.033). Although there is evidence for a good cure of the stress component of MUI, urodynamic investigation with its findings prior to management of MUI could have greater implications for selective patient centered counseling. Presence of DO or DOI on urodynamics resulted in poorer objective and subjective outcomes.

UI MeSH Term Description Entries
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D014549 Urinary Incontinence Involuntary loss of URINE, such as leaking of urine. It is a symptom of various underlying pathological processes. Major types of incontinence include URINARY URGE INCONTINENCE and URINARY STRESS INCONTINENCE. Incontinence, Urinary
D014550 Urinary Incontinence, Stress Involuntary discharge of URINE as a result of physical activities that increase abdominal pressure on the URINARY BLADDER without detrusor contraction or overdistended bladder. The subtypes are classified by the degree of leakage, descent and opening of the bladder neck and URETHRA without bladder contraction, and sphincter deficiency. Urinary Stress Incontinence,Incontinence, Urinary Stress,Stress Incontinence, Urinary
D014563 Urodynamics The mechanical laws of fluid dynamics as they apply to urine transport. Urodynamic
D053825 Suburethral Slings Support structures, made from natural or synthetic materials, that are implanted below the URETHRA to treat URINARY STRESS INCONTINENCE. Male Slings,Male Urethral Slings,Mid-Urethral Slings,Midurethral Slings,Tension-Free Vaginal Tape,Tensionless Vaginal Tape,Trans-Obturator Tape,Transobturator Suburethral Tape,Transobturator Tape,Urethral Slings,Male Sling,Male Urethral Sling,Mid Urethral Slings,Mid-Urethral Sling,Midurethral Sling,Sling, Male,Sling, Male Urethral,Sling, Mid-Urethral,Sling, Midurethral,Sling, Suburethral,Sling, Urethral,Slings, Male,Slings, Male Urethral,Slings, Mid-Urethral,Slings, Midurethral,Slings, Suburethral,Slings, Urethral,Suburethral Sling,Suburethral Tape, Transobturator,Suburethral Tapes, Transobturator,Tape, Tension-Free Vaginal,Tape, Tensionless Vaginal,Tape, Trans-Obturator,Tape, Transobturator,Tape, Transobturator Suburethral,Tapes, Tension-Free Vaginal,Tapes, Tensionless Vaginal,Tapes, Trans-Obturator,Tapes, Transobturator,Tapes, Transobturator Suburethral,Tension Free Vaginal Tape,Tension-Free Vaginal Tapes,Tensionless Vaginal Tapes,Trans Obturator Tape,Trans-Obturator Tapes,Transobturator Suburethral Tapes,Transobturator Tapes,Urethral Sling,Urethral Sling, Male,Urethral Slings, Male,Vaginal Tape, Tension-Free,Vaginal Tape, Tensionless,Vaginal Tapes, Tension-Free,Vaginal Tapes, Tensionless

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