The Analysis of Persistent Overactive Bladder Syndrome after Sling Surgery in Female Stress Urinary Incontinence / 대한비뇨기과학회지

ABSTRACT

PURPOSE: The ability of preoperative findings, to identify patients where an overactive bladder syndrome failed to resolve postoperatively, was assessed. The clinical outcome of a pubovaginal sling was also evaluated to determine the correlation between the postoperative success rate (subjective, objective) and satisfaction in overactive bladder syndrome. MATERIALS AND METHODS: Thirty three women, with stress urinary incontinence, received a pubovaginal sling procedure using polypropylene mesh. All the preoperative factors that affect the presence of preoperative overactive bladder syndrome, and the postoperative changes in overactive bladder syndrome, were analyzed and evaluated. The correlation between the changes in overactive bladder syndrome and the success rate (subjective, objective) and satisfaction were also analyzed. RESULTS: The presence of preoperative overactive bladder syndrome was significantly related to a decrease in the Valsalva leak point pressure (p=0.05) and an increase of the Stamey grade (p<0.05), and was closely related to the Valsalva type (p=0.07) and the open bladder neck at rest, with the patient erect (p=0.07). The differences in the Blaivas type, Q tip angle, posterior urethrovesical angle and bladder neck descending in the strain lateral view of a cystourethrogram, between the resolved and persistent patients of overactive bladder syndrome postoperatively, were statistically significant (p<0.05). Preoperative urgency, urge incontinence and persistence of postoperative overactive bladder syndrome, are significant factors contributing to decreases in the subjective success rate and patient satisfaction (p<0.05). CONCLUSIONS: Preoperative overactive bladder syndrome was closely associated with the variables related to incompetence of the urethra, and the postoperative persistence of overactive bladder syndrome was associated with the variables related not only to incompetence of the urethra, but also to the urethral hypermobility.