Preoperative screening for latent stress incontinence in women with cystocele

Abstract

A preoperative urodynamic investigation with and without a vaginal pessary ring including simultaneous urethrocystometry and urethral pressure profiles in supine and standing position during coughing was evaluated in 41 continent women with cystocele. Following the application of the vaginal pessary ring, loss of urine was demonstrated in six patients, in whom a negative urethral closure pressure was found only when the pessary ring was inserted, suggesting that latent stress incontinence might become manifest after surgical repair of the cystocele. These patients were all continent during the follow‐up period of 12–18 months after Manchester repair combined with urethrocystopexy. The remaining 35 patients with normal urodynamic registrations with and without an inserted pessary ring had no signs of urinary incontinence during the follow‐up period after the Manchester repair. Thus, the present urodynamic screening was found to be valuable for preoperative selection of an adequate surgical method in order to avoid postoperatively manifest stress incontinence after anterior colporaphy.