Prevalence and management of urinary incontinece after pelvic organ prolapse surgery (sacrocolpopexy). A literature review

Abstract

Introduction: Stress urinary incontinence (SUI) is frequently associated with pelvic organ prolapse (POP) and may occur after its surgical treatment.

Aim: To determine the incidence, risk factors and management of SUI during and after POP surgery through a review of the available literature.

Materials and method: Narrative literature review on the incidence and management of SUI after POP surgery after search of relevant manuscripts indexed in PubMed, EMBASE and Scielo published in Spanish and English between 2013 and 2023.

Results: Occult SUI is defined as visible urine leakage when prolapse is reduced in patients without SUI symptoms. De novo SUI develops after prolapse surgery without having previously existed. In continent patients, the number needed to treat (NNT) to prevent one case of de novo SUI is estimated to be 9 patients and about 17 to avoid repeat incontinence surgery. In patients with occult UI, the NNT to avoid repeat incontinence surgery is around 7. Patients with POP and concomitant SUI are the group most likely to benefit from combined surgery with a more favorable NNT (NNT 2).

Conclusion: Quality studies on combined surgery for treatment SUI and POP repair are lacking. Continent patients with prolapse should be warned of the risk of de novo SUI, although concomitant incontinence treatment is not currently recommended. Incontinence surgery should be considered on an individual basis in patients with prolapse and SUI.

Keywords: Cirugía prolapso; Colposacropexia; Incontinencia urinaria; Incontinencia urinaria esfuerzo; Prolapse surgery; Sacrocolpopexy; Stress urinary incontinence; Urinary incontinence.