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Advances in Urology
Volume 2013 (2013), Article ID 567375, 8 pages
http://dx.doi.org/10.1155/2013/567375
Research Article

Risk Factors for Urgency Incontinence in Women Undergoing Stress Urinary Incontinence Surgery

1Departments of Urology and Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, Female Pelvic Medicine & Reconstructive Surgery, Yale-New Haven Hospital, Yale University, 310 Cedar Street, FMB 329E, New Haven, CT 06519, USA
2New England Research Institute, Watertown, MA, USA
3University of Texas Southwestern Medical Center, Dallas, TX, USA
4University of Utah, Salt Lake City, UT, USA
5Boston Children’s Hospital, Boston, MA, USA
6Loyola University Medical Center, Maywood, IL, USA

Received 18 July 2013; Revised 12 September 2013; Accepted 13 September 2013

Academic Editor: Nazareno Suardi

Copyright © 2013 Leslie M. Rickey et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To determine baseline variables associated with urgency urinary incontinence (UUI) in women presenting for stress urinary incontinence (SUI) surgery. Methods. Baseline data from two randomized trials enrolling 1,252 women were analyzed: SISTEr (fascial sling versus Burch colposuspension) and TOMUS (retropubic versus transobturator midurethral sling). Demographic data, POP-Q measures, and validated measures of symptom severity and quality of life were collected. Charlson Comorbidity Index (CCI) and Patient Health Questionnaire-9 were measured in TOMUS. Multivariate models were constructed with UUI and symptom severity as outcomes. Results. Over two-thirds of subjects reported bothersome UUI at baseline. TOMUS patients with more comorbidities had higher UDI irritative scores (CCI score 0 = 39.4, CCI score 1 = 42.1, and CCI score 2+ = 51.0, ), and higher depression scores were associated with more severe UUI. Smoking, parity, prior incontinence surgery/treatment, prolapse stage, and incontinence episode frequency were not independently associated with UUI. Conclusions. There were no modifiable risk factors identified for patient-reported UUI in women presenting for SUI surgery. However, the direct relationships between comorbidity level, depression, and worsening of UUI/urgency symptoms may represent targets for preoperative intervention. Further research is necessary to elucidate the pathophysiologic mechanisms that explain the associations between these medical conditions and bladder function.