Incidence and characteristics of de novo stress urinary incontinence after pelvic organ prolapse vaginal repair

  • Suskhan Djusad Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Ihya Ridlo Nizomy Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Lambung Mangkurat, Ulin General Hospital, South Kalimantan, Indonesia
  • Surahman Hakim Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Tyas Priyatini Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0003-3330-9824
  • Fernandi Moegni Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0001-9537-4256
  • Alfa Putri Meutia Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0002-5966-4034
  • Budi Iman Santoso Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia https://orcid.org/0000-0001-5207-9388
Keywords: gynecologic surgery, pelvic organ prolapse, tertiary referral center, urinary stress incontinence
Abstract viewed: 1460 times
PDF downloaded: 798 times
HTML downloaded: 313 times
EPUB downloaded: 300 times

Abstract

BACKGROUND Some patients who undergo pelvic floor reconstruction for pelvic organ prolapse (POP) may experience a de novo stress urinary incontinence (SUI) postoperatively. We aimed to investigate the incidence and characteristics of de novo SUI in patients who underwent pelvic floor reconstruction at the national referral hospital in Indonesia.

METHODS This cross-sectional study evaluated 108 patients who underwent pelvic floor reconstruction due to POP between January 2016 and December 2017. Per the inclusion criteria, 75 women were enrolled using a consecutive sampling. The incidence of de novo SUI was determined 6–12 months postoperatively using the Indonesian version of the questionnaire for urinary incontinence diagnosis and objectively using the cough stress test during gynecologic examination after a negative preoperative prolapse reduction stress test.

RESULTS The average age, parity, body mass index, and years since menopause onset were 56.17 (4.67) years, 3.17 (1.07), 28.58 (5.18) kg/m2, and 12.8 (7.0) years, respectively. De novo SUI was seen in 8.0% (6 of 75) patients at 6–7 months postoperatively, with 3 (50.0%) had severe POP and 3 (50.0%) had a mild POP. Most of these patients (4 of 6, 66.7%) had undergone procedures other than colpocleisis for POP reconstruction.

CONCLUSIONS The incidence of de novo SUI after gynecologic surgery for POP at a national referral hospital in Indonesia is 8%. Most patients were aged <60 years, had a parity of <4, were nonobese, were menopausal, and had diabetes.

References

  1. Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers. 2017;3:17042. https://doi.org/10.1038/nrdp.2017.97

  2. Sumardi R, Mochtar CA, Junizaf, Santoso BI, Setiati S, Nuhonni SA, et al. Prevalence of urinary incontinence, risk factors and its impact: multivariate analysis from Indonesian nationwide survey. Acta Med Indones. 2014;46(3):175-82.

  3. Wang SY, Cao TT, Wang RZ, Yang X, Sun XL, Wang JL. Incidence and risk factors of de novo stress urinary incontinence after pelvic floor reconstruction: a nested case-control study. 2017. Chin Med J. 2017;130(6):678-83. https://doi.org/10.4103/0366-6999.201592

  4. Alas AN, Chinthakanan O, Espaillat L, Plowright L, Davila GW, Aguilar VC. De novo stress urinary incontinence after pelvic organ prolapse surgery in women without occult incontinence. Int Urogynecol J. 2017;28(4):583-90. https://doi.org/10.1007/s00192-016-3149-7

  5. Fakhrizal E, Priyatini T, Santoso BI, Junizaf J, Moegni F, Djusad S, et al. Prevalence and risk factors of persistent stress urinary incontinence at three months postpartum in Indonesian women. Med J Indones. 2016;25(3):163-70. https://doi.org/10.13181/mji.v25i3.1407

  6. Putra IGM, Megadhana IW, Suwiyoga K, Junizaf, Santoso BI. Prevalence of urinary incontinence in women with pelvic organ prolapse at Sanglah hospital Denpasar, Bali-Indonesia. Bali Med J. 2016;5(1):125-8. https://doi.org/10.15562/bmj.v5i1.263

  7. Developed by the Joint Writing Group of the American Urogynecologic Society and the Internasional Urogynecological Association. Joint report on terminology for surgical procedures to treat pelvic organ prolapse. Female Pelvic Med Reconstr Surg. 2020;26(3):173-201. https://doi.org/10.1097/SPV.0000000000000846

  8. Persu C, Chapple CR, Cauni V, Gutue S, Geavlete P. Pelvic organ prolapse quantification system (pop-q) - a new era in pelvic prolapse staging. J Med Life. 2011;4(1):75-81.

  9. Borstad E, Rud T. The risk of developing urinary stress-incontinence after vagina repair in continent woman. A clinical and urodynamic follow-up study. Acta Obstet Gynecol Scand. 1989;68(6):545-9. https://doi.org/10.1111/j.1600-0412.1989.tb07836.x

  10. Colombo M, Maggioni A, Zanetta G, Vignali M, Milani R. Prevention of postoperative urinary stress incontinence after surgery for genitourinary prolapse. Obstet Gynecol. 1996;87(2):266-71. https://doi.org/10.1016/0029-7844(95)00378-9

  11. Aungst MJ, Friedman EB, von Pechmann WS, Horbach NS, Welgoss JA. De novo stress incontinence and pelvic muscle symptoms after transvaginal mesh repair. Am J Obstet Gynecol. 2009;201(1):73.e1-7. https://doi.org/10.1016/j.ajog.2009.02.028

  12. Kasturi S, Diaz SI, McDermott CD, Woodman PJ, Bump RC, Terry CL, et al. De novo stress urinary incontinence after negative prolapse reduction stress testing for total vaginal mesh procedures: incidence and risk factors. Am J Obstet Gynecol. 2011;205(5);487.e1-4. https://doi.org/10.1016/j.ajog.2011.07.006

  13. Al-Mandeel H, Ross S, Robert M, Milne J. Incidence of stress urinary incontinence following vaginal repair of pelvic organ prolapse in objectively continent women. Neurourol Urodyn. 2011;30(3):390-4. https://doi.org/10.1002/nau.20947

  14. Hafidh BA, Chou Q, Khalil MM, Al-Mandeel H. De novo stress urine incontinence after vaginal repair for pelvic organ prolapse: one-year follow-up. Eur J Obstet Gynecol Reprod Biol. 2013;168(2):227-30. https://doi.org/10.1016/j.ejogrb.2012.12.029

  15. Leruth J, Fillet M, Waltregny D. Incidence and risk factors of postoperative stress urinary incontinence following laparoscopy sacrocolpopexy in patients with negative preoperative prolapse reduction stress testing. Int Urogynecol J. 2013:24(3);485-91. https://doi.org/10.1007/s00192-012-1888-7

  16. Lo TS, Bt Karim N, Nawawi EA, Wu PY, Nusee Z. Predictors for de novo stress urinary incontinence following extensive pelvic reconstructive surgery. Int Urogynecol J. 2015;26(9):1313-9. https://doi.org/10.1007/s00192-015-2685-x

  17. Kanasaki H, Oride A, Mitsuo T, Miyazaki K. Occurrence of pre- and postoperative stress urinary incontinence in 105 patients who underwent tension-free vaginal mesh surgery for pelvic organ prolapse: a retrospective study. ISRN Obstet Gynecol. 2014;2014:643495. https://doi.org/10.1155/2014/643495

  18. Wang J, Chu L, Guo Y, Li L, Gao T, Li H, et al. Urinary incontinence after surgical repair in patients with pelvic organ prolapse. Biomed Res. 2014;25(4):588-91.

  19. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010;21(1):5-26. https://doi.org/10.1007/s00192-009-0976-9

  20. Jundt K, Wagner S, von Bodungen V, Friese K, Peschers UM. Occult incontinence in women with pelvic organ prolapse - does it matter? Eur J Med Res. 2010;15(3):112-6. https://doi.org/10.1186/2047-783X-15-3-112

  21. Wei JT, Nygaard I, Richter HE, Nager CW, Barber MD, Kenton K, et al. A midurethral sling to reduce incontinence after vaginal prolapse repair. N Engl J Med. 2012;366(25):2358-67. https://doi.org/10.1056/NEJMoa1111967

  22. Bergman A, Koonings PP, Ballard CA. Predicting postoperative urinary incontinence development in women undergoing operation for genitourinary prolapse. Am J Obstet Gynecol. 1988;158(5):1171-5. https://doi.org/10.1016/0002-9378(88)90248-7

  23. Ellström Engh AM, Ekeryd A, Magnusson A, Olsson I, Otterlind L, Tobiasson G. Can de novo stress incontinence after anterior wall repair be predicted? Acta Obstet Gynecol Scand. 2011;90(5):488-93. https://doi.org/10.1111/j.1600-0412.2011.01087.x

  24. Jelovsek JE, Chagin K, Brubaker L, Rogers RG, Richter AE, Arya L, et al. A model for predicting the risk of de novo stress urinary incontinence in women undergoing pelvic organ prolapse surgery. Obstet Gynecol. 2014;123(201):279-87. https://doi.org/10.1097/AOG.0000000000000094

Published
2021-11-23
How to Cite
1.
Djusad S, Nizomy IR, Hakim S, Priyatini T, Moegni F, Meutia AP, Santoso BI. Incidence and characteristics of <em>de novo</em&gt; stress urinary incontinence after pelvic organ prolapse vaginal repair. Med J Indones [Internet]. 2021Nov.23 [cited 2024Apr.20];30(4):245-9. Available from: http://mji.ui.ac.id/journal/index.php/mji/article/view/4163
Section
Clinical Research