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Opening detrusor pressure and the influence of age on success following colposuspension

Lookup NU author(s): Dr Lucia Dolan

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Abstract

Women with urodynamic stress incontinence (USI) have lower opening and closing detrusor pressures than women without USI. This study was undertaken to determine whether a change occurs in opening and closing detrusor pressures after colposuspension, whether cure is associated with change, and whether age influences cure. Design: Retrospective cohort study. Setting: Tertiary referral urogynaecology department. Participants: Consecutive women who had undergone colposuspension between 1998-2000 and 1993-1995. Methods: Pre- and postoperative urodynamic records were reviewed. Eighty eight women were included. Objective cure was defined as an absence of USI and subjective cure as an absence of symptoms of stress incontinence. Results: Mean age was 52.4 (11.0) years. Sixty nine percent (61/88) were objectively cured and 48% (42/88) were subjectively cured. Postoperatively, opening detrusor pressure increased (P = 0.0001) and maximum flow rate decreased (P = 0.0464) in women objectively cured but these parameters did not change in the not cured group (P > 0.05). Women had a 4.5 times higher chance of failed surgery if post-op opening detrusor pressure was less than or equal to 20 cmH(2)O (P = 0.035). Opening detrusor pressure declined with age (P < 0.001) and women who were objectively cured were on average almost 7 years younger (P = 0.0330). Conclusions: Increase in opening detrusor pressure occurs only in women who are cured following colposuspension. Change in opening detrusor pressure is dependent on age and objective cure is higher in younger women. The effects of ageing on suburethral supports might explain why surgery is more likely to fail in older women. (C) 2003 Wiley-Liss, Inc.


Publication metadata

Author(s): Dolan LM, Smith ARB, Hosker GL

Publication type: Article

Publication status: Published

Journal: Neurourology and Urodynamics

Year: 2004

Volume: 23

Issue: 1

Pages: 10-15

ISSN (print): 0733-2467

ISSN (electronic): 1520-6777

Publisher: John Wiley & Sons, Inc.

URL: http://dx.doi.org/10.1002/nau.10165

DOI: 10.1002/nau.10165


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