Urodynamic predictors of de novo overactive bladder after single-incision sling.

The aim of the study was to identify urodynamic predictors for de novo overactive bladder (OAB) after single-incision sling implantation.

This retrospective study analysed women with pure, urodynamically proven stress urinary incontinence, without OAB, between 2008 and 2015, in a university hospital. De novo OAB was investigated during clinical interviews.

192 patients were analyzed. 21 patients with de novo OAB were considered as group A while 171 control patients as group B. Univariate analysis demonstrated that patients with de novo OAB have the first desire to void at lower bladder volume (124 ml vs 160 ml, p=0.0052), less maximum cystometric capacity (357 ml vs 406 ml, p=0.0061), lower maximum flow (17 ml/s vs 23 ml/s, p=0.0006) and higher bladder outlet obstruction index (BOOI; -11 vs -23, p=0.0022) compared to controls. According to multivariate analysis, maximum cystometric capacity (PE=0.008, p=0.04) and BOOI (PE=-0.029, p=0.01) resulted as independent urodynamic predictors of de novo OAB. The final model resulted in a good predictive accuracy (AUC=0.81).

Our study identified maximum cystometric capacity and BOOI as independent predictors of de novo overactive bladder after single-incision sling implantation. Therefore, preoperative urodynamics may be useful to improve preoperative counselling and tailor surgical treatment.

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2020 Nov 29 [Epub ahead of print]

Stefano Manodoro, Marta Barba, Luca Locatelli, Stefania Palmieri, Giuseppe Marino, Matteo Frigerio

ASST Santi Paolo e Carlo, San Paolo Hospital, Milano, Italy., University Milano-Bicocca, Monza, Italy., ASST Monza, San Gerardo Hospital, Monza, Italy.

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