High urinary flow in women with stress incontinence: corrected flow-age nomogram evaluation after a transobturator tape procedure

Int Urogynecol J. 2016 Jul;27(7):1075-80. doi: 10.1007/s00192-016-2943-6. Epub 2016 Jan 25.

Abstract

Introduction and hypothesis: We noninvasively compared urinary flow in both pre- and post-transobturator tape (TOT) procedures in stress urinary incontinence (SUI) patients using previously reported corrected flow-age nomograms in healthy women.

Methods: This retrospective cohort study included patients who underwent a successful TOT procedure to treat SUI. Non-instrumented uroflowmetry was performed before and 3 months after surgery. Corrected maximum flow rate (cQmax) and average flow rate (cQave) were calculated using Qmax/√voided volume (VV) and Qave/√VV respectively. The ratio of corrected flow to age-adjusted corrected flow in healthy women was calculated in each patient. Each parameter was compared against pre-TOT and 3-months post-TOT values.

Results: Sixty-two patients were eligible for study inclusion. All urinary flow parameters were significantly higher pre-TOT than at 3 months post-TOT. The number of patients with cQmax and cQave over mean flow-age nomogram, compared with healthy women, before the TOT procedure decreased 3 months post-TOT; however, in many patients, cQmax and cQave were higher than in the corrected flow-age nomogram post-TOT. No significant difference in the ratio of cQmax to age-adjusted cQmax between pre- and post-TOT in the normal urinary flow group was observed, but significantly decreased in the high urinary flow group 3 months after TOT.

Conclusions: Urinary flow rates were higher in SUI patients compared with age-matched controls and successful TOT procedures normalized urinary flows in patients with high urinary flow. A simple evaluation of urinary flow using a corrected flow-age nomogram may be clinically useful in SUI patients.

Keywords: Corrected flow–age nomogram; Stress urinary incontinence; Urinary flow rate.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gynecologic Surgical Procedures*
  • Humans
  • Middle Aged
  • Nomograms
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Suburethral Slings
  • Urinary Incontinence, Stress / physiopathology*
  • Urinary Incontinence, Stress / surgery
  • Urodynamics*