Predictors of persistent detrusor overactivity after transvaginal sling procedures

Tondalaya L. Gamble, Sylvia M. Botros, Jennifer L. Beaumont, Roger P. Goldberg, Jay James R. Miller, Oyinlolu Adeyanju, Peter K. Sand

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

Objective: Determine predictors of persistent postoperative detrusor overactivity and urge urinary incontinence after sling procedures for stress urinary incontinence. Study Design: Three hundred five women with mixed urinary incontinence underwent sling procedures for stress urinary incontinence. Risk factors for persistent detrusor overactivity and urge urinary incontinence were examined using logistic regression models. Results: Women (31.5%) who had postoperative resolution of detrusor overactivity. Transobturator slings had the lowest rate of persistent detrusor overactivity (53%), followed by retropubic (SPARC = 66%; TVT = 64%) and bladder neck slings (86%). Predictors for persistent detrusor overactivity included age (odds ratio [OR], 1.38; P = .001), prior hysterectomy (OR, 1.95; P = .012), paravaginal repair (OR, 0.46; P = .015), nocturia (OR, 1.91; P = .013), maximum cystometric capacity (OR, 0.79; P < .001), detrusor overactivity volume (OR, 0.83; P = .006), urethral closure pressure (OR, 0.83; P < .001), and maximum urinary flow rate (OR, 0.77; P = .014). Persistent urge urinary incontinence was predicted by sling type (P < .001). Conclusion: When treating women with mixed urinary incontinence, age, nocturia, maximum cystometric capacity, and choice of sling procedure impact persistence of detrusor overactivity and urge urinary incontinence.

Original languageEnglish (US)
Pages (from-to)696.e1-696.e7
JournalAmerican Journal of Obstetrics and Gynecology
Volume199
Issue number6
DOIs
StatePublished - Dec 2008
Externally publishedYes

Keywords

  • detrusor overactivity
  • overactive bladder
  • stress urinary incontinence
  • transvaginal sling
  • urge urinary incontinence
  • urodynamics

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Gamble, T. L., Botros, S. M., Beaumont, J. L., Goldberg, R. P., Miller, J. J. R., Adeyanju, O., & Sand, P. K. (2008). Predictors of persistent detrusor overactivity after transvaginal sling procedures. American Journal of Obstetrics and Gynecology, 199(6), 696.e1-696.e7. https://doi.org/10.1016/j.ajog.2008.07.059