To evaluate the role of preoperative abdominal straining in predicting de novo overactive bladder (OAB) and voiding dysfunction in female patients undergoing suburethral taping by trans-obturator approach (TVT-O) for uncomplicated stress urinary incontinence (SUI).
Data from patients who underwent TVT-O surgery for SUI were retrospectively analyzed. Inclusion criteria included: history of pure SUI. Exclusion criteria included previous surgery for urinary incontinence, pelvic radiation, pelvic surgery within the last 3 months, and anterior or apical pelvic organ prolapse (POP) ⩾ +1 cm. Voiding dysfunction has been defined through symptoms and or urodynamics (UDS) signs. Accordingly, patients were divided into group A and group B according to the presence of abdominal straining during UDS. Patients were observed clinically and with UDS at a 3-year follow-up.
A total of 192 patients underwent TVT-O surgery for uncomplicated SUI. Preoperative abdominal straining was identified in 60/192 patients (Group A: 31.2% vs Group B: 68.8%). Qmax was not different in the two groups (Group A: 19.5 vs Group B: 20.5 mL/s, p = 0.76). Demographics was similar for the two groups regarding age, parity. At 3-year follow-up, voiding dysfunction was reported in Group A: 9 and Group B: 8 patients (p = 0.056), de novo OAB was significantly reported in Group A: 23 and Group B: 26 patients (p = 0.007).
Preoperative abdominal straining was found to be related to a significant incidence of de novo OAB. A significant correlation was not assessed for postoperative voiding dysfunction. Further studies may better define the impact of preoperative abdominal straining.
Therapeutic advances in urology. 2021 Nov 24*** epublish ***
Valerio Iacovelli, Maurizio Serati, Daniele Bianchi, Andrea Braga, Andrea Turbanti, Enrico Finazzi Agrò
Department of Surgical Sciences, Urology Unit, San Carlo di Nancy Hospital, GVM Care and Research, University of Rome Tor Vergata, Via Aurelia 275, 00165 Rome, Italy., Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy., Department of Surgical Sciences, Urology Unit, University of Rome Tor Vergata, Rome, Italy., Department of Obstetrics and Gynecology, EOC - Beata Vergine Hospital, Mendrisio, Switzerland., Policlinico Tor Vergata University Hospital, Rome, Italy.