The Incidence of Occult Stress Incontinence in Patients without Urinary Complaints Undergoing Surgery for Advanced Pelvic Organ Prolapse
Drs. Steven Kleeman, Brett J. Vassallo, Jeffrey Segal
Seton Center
Cincinnati, Ohio

Objective: To determine incidence of occult stress incontinence in patients without associated urinary complaints who are undergoing surgical repair of advanced pelvic organ prolapse.
Methods: A retrospective chart review was done on all patients who denied any urinary complaints and had repair of advanced pelvic organ prolapse, grade 2 or greater, without the addition of an anti-incontinence procedure.  All patients had simple cystometry with prolapse reduction at the time of initial examination that failed to suggest stress incontinence or detrusor instability.   Any urinary dysfunction that developed postoperatively was noted.
Results: A total of fifty-four patients met inclusion criteria.  Of these patients, one patient (1.8%) developed genuine stress incontinence, one patient complained of urgency (1.8%), and one patient complained of frequency (1.8%) that resolved with oxybutinin.
Conclusion: Patients without urinary complaints and a negative standardized office filling reduction study who present for surgical correction of advanced pelvic organ prolapse have a low incidence of developing occult stress incontinence.  Further work-up would not be cost effective.
Key Words: pelvic organ prolapse, occult urinary incontinence, reconstructive pelvic surgery