What happens to urinary incontinence after pelvic organ prolapse surgery?

Int Urogynecol J. 2019 Jul;30(7):1147-1152. doi: 10.1007/s00192-018-3677-4. Epub 2018 Jun 5.


Introduction and hypothesis: The beneficial effect of pelvic organ prolapse (POP) surgery on urge urinary incontinence (UI) is well described in the literature, while effect on preoperative stress UI (SUI) is still unclear. The aim of this study was to investigate changes concerning UUI following POP surgery without concomitant anti-incontinence procedures and to identify possible factors influencing the changes.

Methods: We conducted a retrospective study of 678 women with prolapse surgery using native tissue repair during a 3-year period. Patients completed three prolapse questions from the International Consultation on Incontinence-Vaginal Symptoms (ICIQ-VS) questionnaire and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) before undergoing surgery and 3 months postoperatively. Patients who scored >0 on the ICIQ-UI SF before surgery were included in the study.

Results: A total of 379 patients (55.9%) with POP had concomitant UI. At 3 months' follow-up, 174 patients (46%) became continent compared with 205 patients (54%) with UI. Patients with remaining UI had statistically significant higher mean preoperative ICIQ-UI SF score than patients who became dry. The risk of remaining UI after POP surgery was greater in patients with previous anti-incontinence repair. UI type was not a risk factor for its persistance.

Conclusion: Almost half of the patients with UI before POP surgery became completely dry after prolapse surgery alone. Severity of incontinence and previous anti-incontinence surgery were identified as risk factors for persisting UI after POP surgery. We found a reduction of incontinence after an operation in any of the three compartments.

Keywords: Pelvic organ prolapse; Surgery; Urinary incontinence.

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Female
  • Humans
  • Middle Aged
  • Pelvic Organ Prolapse / epidemiology*
  • Pelvic Organ Prolapse / surgery
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / statistics & numerical data
  • Postoperative Period
  • Preoperative Period
  • Quality of Life
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urinary Incontinence / epidemiology*
  • Young Adult