Preoperative voiding detrusor pressures do not predict stress incontinence surgery outcomes

International Urogynecology Journal - Tập 22 - Trang 657-663 - 2010
Anna C. Kirby1, Charles W. Nager1, Heather J. Litman2, Mary P. FitzGerald3, Stephen Kraus4, Peggy Norton5, Larry Sirls6, Leslie Rickey7, Tracey Wilson8, Kimberly J. Dandreo2, Jonathan P. Shepherd9, Philippe Zimmern10
1Reproductive Medicine, University of California San Diego, San Diego, USA
2New England Research Institute, Watertown, USA
3Obstetrics and Gynecology, Loyola University Medical Center, Maywood, USA
4Urology, University of Texas Health Sciences Center, San Antonio, USA
5Obstetrics and Gynecology, University of Utah, Salt Lake City, USA
6Urology, William Beaumont Hospital, Royal Oak, USA
7Urology, University of Maryland, Baltimore, USA
8Urology, University of Alabama at Birmingham, Birmingham, USA
9Obstetrics, Gynecology, and Reproductive Science, Magee Women’s Hospital, University of Pittsburgh, Pittsburgh, USA
10Urology, University of Texas Southwestern, Dallas, USA

Tóm tắt

The aim of this study was to determine whether preoperative voiding detrusor pressures were associated with postoperative outcomes after stress incontinence surgery. Opening detrusor pressure, detrusor pressure at maximum flow (p det Qmax), and closing detrusor pressure were assessed from 280 valid preoperative urodynamic studies in subjects without advanced prolapse from a multicenter randomized trial comparing Burch and autologous fascia sling procedures. These pressures were compared between subjects with and without overall success, stress-specific success, postoperative detrusor overactivity, and postoperative urge incontinence using independent sample t tests. There were no clinically or statistically significant differences in mean preoperative voiding detrusor pressures in any comparison of postoperative outcomes. We found no evidence that preoperative voiding detrusor pressures predict outcomes in women with stress predominant urinary incontinence undergoing Burch or autologous fascial sling procedures.

Tài liệu tham khảo

Digesu GA, Khullar V, Cardozo L, Sethna F, Salvatore S (2004) Preoperative pressure-flow studies: useful variables to predict the outcome of continence surgery. BJU Int 94:1296–1299 Panayi DC, Duckett J, Digesu GA, Camarata M, Basu M, Khullar V (2009) Pre-operative opening detrusor pressure is predictive of detrusor overactivity following TVT in patients with pre-operative mixed urinary incontinence. Neurourol Urodyn 28:82–85 Tennstedt S (2005) Design of the stress incontinence surgical treatment efficacy trial (SISTEr). Urology 66:1213–1217 Herzog AR, Diokno AC, Fultz NH (1989) Urinary incontinence: medical and psychosocial aspects. Annu Rev Gerontol Geriatr 9:74–119 Crystle CD, Charme LS, Copeland WE (1971) Q-tip test in stress urinary incontinence. Obstet Gynecol 38:313–315 Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-Committee of the International Continence Society. Am J Obstet Gynecol 187:116–126 Schafer W, Abrams P, Liao L, Mattiasson A, Pesce F, Spangberg A et al (2002) Good urodynamic practices: uroflowmetry, filling cystometry, and pressure-flow studies. Neurourol Urodyn 21:261–274 Nager CW, Albo ME, Fitzgerald MP, McDermott SM, Kraus S, Richter HE et al (2007) Process for development of multicenter urodynamic studies. Urology 69:63–67, discussion 67–68 Nager CW, Albo ME, Fitzgerald MP, McDermott S, Wruck L, Kraus S et al (2007) Reference urodynamic values for stress incontinent women. Neurourol Urodyn 26:333–340 Sullivan J, Lewis P, Howell S, Williams T, Shepherd AM, Abrams P (2003) Quality control in urodynamics: a review of urodynamic traces from one centre. BJU Int 91:201–207 Abrams P (2006) Urodynamics. Springer, London, p 75 Albo ME, Richter HE, Brubaker L, Norton P, Kraus SR, Zimmern PE et al (2007) Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med 356:2143–2155 Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17 Hintze J. (2008) PASS 2008. NCSS, LLC. Kaysville, Utah. www.ncss.com Brubaker L, Stoddard A, Richter H, Zimmern P, Moalli P, Kraus SR et al (2009) Mixed incontinence: comparing definitions in women having stress incontinence surgery. Neurourol Urodyn 28:268–273 Nager CW, FitzGerald M, Kraus SR, Chai TC, Zyczynski H, Sirls L et al (2008) Urodynamic measures do not predict stress continence outcomes after surgery for stress urinary incontinence in selected women. J Urol 179:1470–1474 Richter HE, Goode PS, Brubaker L, Zyczynski H, Stoddard AM, Dandreo KJ et al (2008) Two-year outcomes after surgery for stress urinary incontinence in older compared with younger women. Obstet Gynecol 112:621–629 Richter HE, Diokno A, Kenton K, Norton P, Albo M, Kraus S et al (2008) Predictors of treatment failure 24 months after surgery for stress urinary incontinence. J Urol 179:1024–1030