• Anis Kaldawy, Nadav Cohen, Wisam Assaf, Meirav Schmidt, Ofer Lavie, and Yoram Abramov.
• Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel, Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.
• Isr Med Assoc J. 2023 Jan 1; 25 (1): 596359-63.

BackgroundDiagnosing occult stress urinary incontinence (OSUI) prior to surgical intervention for pelvic organ prolapse (POP) repair may allow for adding an anti-incontinence procedure and thus prevent postoperative SUI.ObjectivesTo compare preoperative detection rates for OSUI by either a multichannel urodynamic investigation or by a plain pelvic examination.MethodsWe retrospectively evaluated the medical charts of all women who underwent urodynamic investigation prior to surgical repair of advanced POP at our institution between 1 January 2006 and 31 December 2012.ResultsIn total, 720 women underwent surgical POP repair during the study period, of whom 54 (7.5%) were diagnosed with OSUI preoperatively. Of these patients, 54 (100%) were detected by multichannel urodynamic investigation while only 27 (50%) were detected by a plain pelvic examination (P = 0.001). Bladder fullness during the pelvic examination was associated with higher detection rates for OSUI (P = 0.001). Women with OSUI who underwent concomitant tension-free vaginal tape and POP repair procedures did not develop de novo SUI or obstructive voiding symptoms (OVS) postoperatively.ConclusionsPreoperative multichannel urodynamic investigation has significantly higher detection rates for OSUI than a plain pelvic examination. Utilizing this modality resulted in no cases of de novo SUI or OVS postoperatively.

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