Can We Predict De Novo Urge Incontinence by Perineal Ultrasound

Introduction: Urinary incontinence affects over 200 million people worldwide [1]. Tension free vaginal tape is the standard surgical treatment for stress urinaryincontinence. De novo urge urinary incontinence is a long-term complication of this treatment with asignificant impact in the quality of life of these patients. Objective: The major aim of this study is to assess the correlation between perineal ultrasonographyfindings and the incidence of de novo urge urinary incontinence. Material and Methods: A prospective observational study was designed. Patients with stressurinary incontinence diagnosed by clinical and urodynamic findings submitted toa tension-free vaginal tape surgery were included. InternationalConsultation on Incontinence Questionnaire-ShortForm (ICIQ-SF) and introital perineal ultrasound were performed before surgicalintervention (I-STOPu0026copy). Clinical and ultrasound re-evaluation were executed six monthsafter surgery. Stress urinary incontinence was defined according to theICS-IUGA. Data were recorded using a Microsoft Access database and statistical analysisusing SASu0026copy. Results: Bladder thickness equal to orbelow 6 mm has a low positive predictive value (PPV, 0.55),but a negative predictive power (NPP) of 0.72. Following surgery, a slightincrease in postvoid residue is observed. Considering demographic data, an increaseof 5 points in body mass index (BMI) resulted in an odds ratio (OR) of 1.74 of presenting denovo urge urinary in continence. Conclusions: In patients submitted to a tension-free vaginal tape surgery, high BMIseems to be associated with a higher rate of de novo urge urinary incontinence.Preoperative bladder wall thickness below 6 mm seems predict absence of this complication.