Rates and Risk Factors for Future Stress Urinary Incontinence Surgery After Pelvic Organ Prolapse Repair in a Large Population Based Cohort in California

To determine the rate and risk factors for future stress incontinence (SUI) surgery in a large population based cohort of previously continent women following pelvic organ prolapse (POP) repair without concomitant SUI treatment.

Data from the Office of Statewide Health Planning and Development (OSHPD) was used to identify all women who underwent anterior, apical or combined antero-apical POP repair without concomitant SUI procedures in the state of California between 2005-2011 with at least one-year follow-up. Patient and surgical characteristics were explored for associations with subsequent SUI procedures.

Of 41,689 women undergoing anterior or apical POP surgery, 1,504 (3.6%) underwent subsequent SUI surgery with a mean follow-up time of 4.1 years. Age (OR 1.01), obesity (OR 1.98), use of mesh at the time of POP repair (OR 2.04), diabetes mellitus (OR 1.19), White race and combined antero-apical repair (OR 1.30) were associated with an increased odds of future SUI surgery.

The rate of subsequent surgery for de novo SUI following POP repair on a population level is low. Patient and surgical characteristics may alter a woman's individual risk and should be considered in surgical planning.

Urology. 2018 Sep 14 [Epub ahead of print]

Raveen Syan, Kai B Dallas, Ericka Sohlberg, Lisa Rogo-Gupta, Christopher S Elliott, Ekene A Enemchukwu

Department of Urology, Stanford University, Stanford, CA. Electronic address: ., Department of Urology, Stanford University, Stanford, CA., Department of Obstetrics & Gynecology, Stanford University, Stanford, CA.