Occult incontinence as predictor for postoperative stress urinary incontinence following pelvic organ prolapse surgery

Abstract

Introduction and hypothesis: Recommending prophylactic anti-incontinence procedures to continent women undergoing surgery for pelvic organ prolapse (POP) is controversial. We hypothesized that testing for occult incontinence before surgery using four different tests and three defined test combinations would identify individual women at risk for postoperative stress urinary incontinence (POSUI). The diagnostic accuracy of these tests and test combinations were evaluated.

Methods: We tested 137 women before and after surgery. Fisher's exact test was used when evaluating associations between test results and outcomes. The validity of each test and test combinations was calculated.

Results: We found a statistically significant association between occult incontinence and POSUI in two tests and all test combinations. However, all tests and test combinations displayed poor performance when predicting at individual levels.

Conclusions: This study confirms a positive association between occult incontinence and POSUI. Occult incontinence does not, however, adequately identify individual women in need of prophylactic anti-incontinence surgery when undergoing POP repair.