Aim. The aim of the study was to compare the incidence of "de novo" overactive bladder (OAB) after sling surgeries and Burch procedure and to analyze the effect of the preoperative bladder volume on the incidence of this condition. Methods. This prospective trial included 290 female patients with stress urinary incontinence (SUI) who were subjected to sling surgeries (TOT or TVT, n=170) or Burch procedure (n=120). Urodynamic testing was performed prior to the surgery and 6 months thereafter. The presence of OAB was diagnosed on the basis of subjective symptoms and urodynamic parameters. Results. The incidence of OAB 3 at 6 months postsurgery was the highest in patients who were subjected to the Burch procedure (14.2% and 17.5%, respectively). The incidence of OAB at 6 months turned out to be significantly higher in patients subjected to the Burch procedure with preoperative bladder volumes greater than 353 ml. We observed the significant postoperative decrease in the bladder volume of women who developed this complication following the Burch procedure. Conclusions. Among surgeries for stress urinary incontinence, Burch procedure is associated with the greatest risk of overactive bladder development. Probably, one reason for the higher incidence of overactive bladder after Burch procedure is the intraoperative reduction of the urinary bladder volume.
BioMed research international. 2019 Feb 12*** epublish ***
Sylwester Ciećwież, Kornel Chełstowski, Agnieszka Brodowska, Magdalena Ptak, Dariusz Kotlęga, Andrzej Starczewski
Department of Gynecology, Endocrinology and Gynecologic Oncology, Pomeranian Medical University in Szczecin, Poland., Chair of Medical Analytics, Department of Laboratory Diagnostics, Pomeranian Medical University in Szczecin, Poland., Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, Poland., Department of Neurology, Pomeranian Medical University in Szczecin, Poland.