Urogenital prolapse and occult stress urinary incontinence


Background A 76-year-old female presented to an outside clinic with symptoms of pelvic prolapse; she denied stress urinary incontinence (SUI). The patient had a history of two prior anti-incontinence surgeries. Pelvic examination revealed a grade IV cystocele. No SUI was identified, with or without reduction of the prolapse. Anterior colporrhaphy with cadaveric fascia was performed. Her prolapse symptoms resolved, but she had new-onset severe SUI.

Investigations Pelvic examination, cystoscopy, urodynamics.

Diagnosis Occult SUI unmasked after anterior colporrhaphy.

Management The patient was referred to our institution where videourodynamics were performed, revealing a well-supported bladder and SUI with Valsalva leak-point pressure of 26 cm H20. A transvaginal polypropylene sling was placed. She had complete resolution of SUI and denied exacerbation of mild urgency.

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Correspondence to Kathleen C Kobashi.

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The authors declare no competing financial interests.

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Yamada, B., Kobashi, K. Urogenital prolapse and occult stress urinary incontinence. Nat Rev Urol 4, 55–58 (2007). https://doi.org/10.1038/ncpuro0699

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