TITLE:
Can We Predict De Novo Urge Incontinence by Perineal Ultrasound?
AUTHORS:
Judith Lleberia, Josep Pubill, Montserrat Mestre, Emma Garcia, Jose M. Gris, Eduardo Bataller
KEYWORDS:
Stress Urinary Incontinence, De Novo Urge, Tension Free Sling, Perineal Ultrasound, Bladder Thickness, Residual Postvoid, BMI
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.3,
March
15,
2018
ABSTRACT: Introduction: Urinary incontinence affects over 200 million people worldwide [1]. Tension free vaginal tape is the standard surgical treatment for stress urinary
incontinence. De novo urge urinary incontinence is a long-term complication of this treatment with a
significant impact in the quality of life of these patients. Objective: The major aim of this study is to assess the correlation between perineal ultrasonography
findings and the incidence of de novo urge urinary incontinence. Material and Methods: A prospective observational study was designed. Patients with stress
urinary incontinence diagnosed by clinical and urodynamic findings submitted to
a tension-free vaginal tape surgery were included. International
Consultation on Incontinence Questionnaire-Short
Form (ICIQ-SF) and introital perineal ultrasound were performed before surgical
intervention (I-STOP©). Clinical and ultrasound re-evaluation were executed six months
after surgery. Stress urinary incontinence was defined according to the
ICS-IUGA. Data were recorded using a Microsoft Access database and statistical analysis
using SAS©. Results: Bladder thickness equal to or
below 6 mm has a low positive predictive value (PPV, 0.55),
but a negative predictive power (NPP) of 0.72. Following surgery, a slight
increase in postvoid residue is observed. Considering demographic data, an increase
of 5 points in body mass index (BMI) resulted in an odds ratio (OR) of 1.74 of presenting de
novo urge urinary in continence. Conclusions: In patients submitted to a tension-free vaginal tape surgery, high BMI
seems to be associated with a higher rate of de novo urge urinary incontinence.
Preoperative bladder wall thickness below 6 mm seems predict absence of this complication.