Urinary incontinence before and after pelvic organ prolapse surgery-A national database study

Introduction and hypothesis To investigate how pelvic organ prolapse (POP) surgery affects symptoms of urinary incontinence (UI) in women with POP and concomitant UI. Methods Data from the Danish Urogynaecological Database were collected from 2013 to 2016. Inclusion criteria were urinary incontinent women who underwent POP surgery alone. Based on the preoperative results of the International Consultation on Incontinence Questionnaire-Urinary Incontinence-short form (ICIQ-UI-sf), women were categorized with stress urinary incontinence (SUI), urgency urinary incontinence (UUI) or mixed urinary incontinence (MUI). Postoperatively, the women were categorized based on the postoperative ICIQ-UI-sf, except here, undefined urinary incontinence and urinary continence were added to the categories. Statistical analyses included multivariate logistic regression analyses, examining the odds of urinary continence in each category. The included parameters were preoperative POP stage (POP-Q), compartment, BMI, age and preoperative ICIQ-UI-sf total score. P-values < 0.05 were considered statistically significant. Results A total of 1657 women were included. Significantly more women with preoperative UUI achieved urinary continence (60%) compared to women with preoperative SUI (52%) and MUI (38%). More than 70% of all women achieved either urinary continence or an improvement in UI, regardless of subtype. For women with UUI, the likelihood of achieving urinary continence was higher if the anterior compartment was involved. Women with MUI were more likely to achieve urinary continence if they had POP-Q stage 3-4. Conclusions Most women with symptomatic POP and concomitant UI find that their UI is either cured or improved after POP surgery alone.

Automated summary

The study investigated the impact of POP surgery on UI in women with POP and concomitant UI. Results showed that the majority of women experienced improvement in UI or achieved urinary continence postoperatively. Women with UUI had higher rates of achieving urinary continence compared to women with SUI and MUI. The involvement of the anterior compartment and POP-Q stage were found to be associated with higher likelihood of achieving urinary continence in specific subtypes of UI.