The evaluation of the tests that can predict de novo stress urinary incontinence after advanced pelvic organ prolapse surgery: a prospective study

BACKGROUND: De novo stress urinary incontinence (SUI) may reduce patient satisfaction following a pelvic organ prolapse (POP) surgery and may necessitate additional anti-incontinence surgery in the future. The aim of this study is to evaluate physical examination tests that can predict de novo SUI after POP surgery. METHODS: A total of 30 patients diagnosed with stage 3-4 POP who underwent POP surgery were included in this study. The results of the Q-tip test, reduced stress test, and urodynamic stress urinary incontinence test, which were performed before the surgery, and stress test results for SUI at 3 and 6 months after the surgery were recorded. The physical examination tests were compared and occult SUI and de novo SUI rates were determined. RESULTS: Occult SUI detection rates were found to be 46.7% for the Q-tip test, 20% for the reduced stress test, and 3.3% for the urodynamic test. The rates of de novo SUI were determined as 3.3% and 10%, respectively, at the 3rd and 6th months postoperatively. The presence of gravida, parity, and the number of living children increased the detection rate of occult SUI by the Q-tip test at statistically significant level. It was also determined that the high number of abortions statistically increased the risk of de novo SUI at 6 months postoperatively and occult SUI did not significantly affect the risk of de novo SUI. CONCLUSION: Our findings suggest that less invasive and cost-effective physical examination tests may be considered in the preoperative evaluation of patients undergoing POP surgery; however, these results should be interpreted cautiously.