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Ringing the changes in evaluation of urogenital prolapse

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International Urogynecology Journal Aims and scope Submit manuscript

An Erratum to this article was published on 03 March 2011

Abstract

Introduction and hypothesis

Some women with pelvic organ prolapse (POP) have occult urodynamic stress incontinence (OUSI) and might develop incontinence after POP surgery. Our aim was to determine predictive value of ring pessary test during urodynamics in identifying patients with OUSI, likely to develop stress urinary incontinence (SUI) postoperatively.

Methods

Women with POP were recruited from surgical lists. All underwent preoperative videocystourethrography (VCU). Women with normal VCUs had tests repeated after pessary reduction of POP.

Results

One hundred and twelve women were studied. Forty-eight women had “normal” VCU. Of these, 43 had no OUSI and only 1/43 developed SUI postoperatively. Five women had OUSI and 2/5 developed frank SUI. The pessary test had poor sensitivity (67%) but high specificity (93%) in predicting postoperative SUI. Positive predictive value was low (40%), with an excellent negative predictive value (98%).

Conclusion

This test can identify patients likely to remain continent following surgery and be a valuable tool in preoperative counselling.

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Acknowledgments

This work was funded by a research grant from Pfizer.

Conflicts of interest

Sushma Srikrishna—Speaker honorarium: Recordati, Astellas, SEP; Advisory board: Astellas. Dudley Robinson—Consultant: Astellas, Ferring, Gynaecare, Uroplasty, Pfizer, Recordati, Novo-Nordisk; speaker honorarium: Astellas, Ferring, Gynaecare, Uroplasty, Pfizer, Recordati; Trial participation: Astellas, Pfizer, Boston Scientific. Linda Cardozo—Consultant: Astellas, Pfizer, Rottapharm, Schering-Plough, SEP; speaker honorarium: Astellas, Pfizer, Rottapharm; Trial participation: Astellas, Pfizer, Boston Scientific

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Authors and Affiliations

  1. Department of Urogynaecology, King’s College Hospital, Denmark Hill, London, SE5 9RS, UK

    Sushma Srikrishna, Dudley Robinson & Linda Cardozo

Authors
  1. Sushma Srikrishna
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  2. Dudley Robinson
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  3. Linda Cardozo
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Corresponding author

Correspondence to Sushma Srikrishna.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00192-011-1388-1

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Srikrishna, S., Robinson, D. & Cardozo, L. Ringing the changes in evaluation of urogenital prolapse. Int Urogynecol J 22, 171–175 (2011). https://doi.org/10.1007/s00192-010-1253-7

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  • DOI: https://doi.org/10.1007/s00192-010-1253-7

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