Evaluating the predictors of cure and overactive bladder syndrome after a mid-urethral sling procedure in women with stress urinary incontinence.

This study evaluated the factors that could predict the cure and overactive bladder (OAB) syndrome after a mid-urethral sling (MUS) procedure in women with stress urinary incontinence (SUI). The study found age and overactivity of the detrusor (bladder) before surgery were independent predictors of persisting/recurrent SUI. OAB before surgery, small voided volume, and overactivity of the detrusor (bladder) before surgery were all predictors of developing OAB after MUS.

Overactive bladder (OAB) occurs when the bladder muscle is too active. Instead of staying at rest as urine fills the bladder, the bladder muscle (detrusor) contracts. This causes a person to feel a sudden and sometimes overwhelming urge to urinate even when the bladder is not full. OAB syndrome is characterized by symptoms such as experiencing incontinence (UI; involuntary leakage of urine), having a strong urge to urinate, and being woken up at night due to the need to urinate (nocturia). OAB symptoms can have a significant negative effect on the quality of life of patients.

Urinary incontinence is the unintentional loss of urine. Stress urinary incontinence (SUI) happens when physical movement or activity — such as coughing, sneezing, running, or heavy lifting — puts pressure (stress) on the bladder. SUI is more common in older women, particularly after giving birth multiple times. MUS is a common surgical treatment option for patients with SUI. The MUS provides support for the urethra (where urine passes through from the bladder) and lowers the chance of SUI occurring again. Many menopausal women have SUI or OAB syndrome. However, there are few studies evaluating the predictors of cure and OAB syndrome after a MUS procedure in women with SUI.

This study involved 385 women with OAB. All patients were treated with MUS for SUI. 68.8% of the patients were menopausal. The average follow-up time was 15.8 months.

Out of 216 women who had OAB before surgery, 109 (50.5%) women experienced resolution of their OAB after MUS. Among the 169 women who did not have OAB before surgery, 25 (14.8%) women developed new OAB after MUS.

Age and overactivity of the detrusor (bladder) before surgery were independent predictors of persisting/recurrent SUI. Women aged 63 or higher were more likely to have persisted/recurrent SUI after MUS.

OAB before surgery, small voided volume, and overactivity of the detrusor (bladder) before surgery were all predictors of developing OAB after MUS.

This study concluded that age and overactivity of the detrusor (bladder) before surgery were independent predictors of persisting/recurrent SUI. OAB before surgery, small voided volume, and overactivity of the detrusor (bladder) before surgery were all predictors of developing OAB after MUS.

This study looked back in time at medical records. Further studies are needed.