Document Detail

Reevaluating occult incontinence.
MedLine Citation:
PMID:  16141769     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Occult incontinence is a controversial subject without significant exposure in the literature. Conventionally, it has been assumed to be a marker for increased risk of postoperative stress urinary incontinence (POSUI) after repair of pelvic organ prolapse. The controversy surrounds the performance of prophylactic incontinence procedures based on this assumption. Until 2004 no article in the English language had been published demonstrating an association between occult incontinence and increased risk of stress urinary incontinence after repair of severe pelvic organ prolapse in previously continent women. We will explore the evidence regarding occult incontinence, review the data on intervention trials, and address questions that remain. RECENT FINDINGS: The limited evidence suggests 11-22% of continent patients with severe pelvic organ prolapse will develop POSUI. New evidence suggests that patients with occult incontinence are at substantially more risk. Since anti-incontinence procedures in patients with occult incontinence reduces the incidence of POSUI (to 0-15%), there appears to be some benefit from screening and intervention. Most studies on the subject are small and limited by their design. Results differ regarding whether a negative stress test can be used to rule out the risk of POSUI. SUMMARY: Minimal existing evidence in the English language suggests that patients with occult incontinence are at increased risk of POSUI. Outcomes in occult incontinence patients undergoing repair of pelvic organ prolapse need systematic study. Until there is adequate solid evidence on the predictive values of our screening test, we cannot counsel patients regarding our ability to prevent POSUI or protect them from unnecessary procedures.
Alexandra L Haessler; Lawrence L Lin; Mat H Ho; Lance H Betson; Narender N Bhatia
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in obstetrics & gynecology     Volume:  17     ISSN:  1040-872X     ISO Abbreviation:  Curr. Opin. Obstet. Gynecol.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-05     Completed Date:  2006-01-31     Revised Date:  2007-04-10    
Medline Journal Info:
Nlm Unique ID:  9007264     Medline TA:  Curr Opin Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  535-40     Citation Subset:  IM    
Urogynecology & Pelvic Reconstructive Surgery, Harbor-UCLA Medical Center, Los Angeles, California 90509, USA.
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MeSH Terms
Postoperative Complications
Urinary Incontinence, Stress / epidemiology,  etiology*,  prevention & control
Urogenital Surgical Procedures / adverse effects*
Uterine Prolapse / surgery*
Comment In:
Eur Urol. 2007 Mar;51(3):850-1   [PMID:  17421062 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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