Diabetes is an independent risk factor for urinary incontinence, and its impact on rates of postoperative incontinence after pelvic reconstructive surgery remains unexplored.
The aim of the study was to compare the incidence of postoperative stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence in patients with diabetes mellitus undergoing surgery for pelvic organ prolapse (POP) with or without SUI surgery.
This is a secondary analysis of a multicenter retrospective cohort study involving 10 diverse medical centers that identified a cohort of women with diabetes who had prolapse and/or anti-incontinence surgery. We compared rates of postoperative urinary incontinence among patients who had surgery for prolapse and incontinence versus surgery for prolapse only.
Three hundred five patients had surgery for prolapse and incontinence, 330 had surgery for prolapse only, and 189 had anti-incontinence surgery only. De novo UUI was higher among those who underwent surgery for POP and SUI compared with surgery for POP alone (26.4% vs 14.1%, P < 0.01). Rates of persistent SUI (21% vs 4.9%, P < 0.01) and mixed urinary incontinence (15.9% vs 2.7%, P < 0.01) were higher for those who underwent prolapse surgery alone versus prolapse and an incontinence procedure. No differences were seen in hemoglobin A1C levels between those who did and did not report postoperative UI.
We found that postoperative de novo UUI rates were high among patients with diabetes after pelvic reconstructive surgery, with the incidence being significantly higher for those who had surgery for prolapse and incontinence compared with surgery for prolapse only.
Female pelvic medicine & reconstructive surgery. 2022 Feb 01 [Epub ahead of print]
Moiuri Siddique, Nancy E Ringel, K Lauren de Winter, Tara Marczak, Cassandra Kisby, Emily Rutledge, Alex Soriano, Parisa Samimi, Michelle Schroeder, Stephanie Handler, Jiling Chou, Robert E Gutman
From the Female Pelvic Medicine and Reconstructive Surgery, Women and Infants Hospital of Rhode Island, Providence, RI Urogynecology & Reconstructive Pelvic Surgery, Yale School of Medicine, New Haven, CT Complete Women Care, Long Beach, CA Female Pelvic Medicine and Reconstructive Surgery, Mount Auburn Hospital, Cambridge, MA Mayo Clinic, Rochester, MN Division of Urogynecology, Houston Methodist Hospital, Houston, TX Division of Urogynecology, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN Female Pelvic Medicine and Reconstructive Surgery, Cooper University Hospital, Camden, NJ Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Harbor-UCLA Medical Center, Torrance, CA Medstar Health Research Institute, Washington, DC.