Voiding symptoms common in women planning SUI surgery

Voiding symptoms are common in women who are planning incontinence surgery, even if they have no prior history of incontinence procedures. That is just one of the surprises from the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr), the largest randomized study of female incontinence surgery ever performed.

The second big surprise: No correlation was seen between presurgical uroflowmetry and other testing and presurgical voiding complaints. Fully 80% of the 655 women enrolled in SISTEr reported voiding complaints before surgery. No difference was reported in voiding symptoms based on normal versus abnormal voiding patterns, as measured by non-instrumented uroflowmetry, researchers reported at the AUA annual meeting yesterday.

Older women and women who had had prior incontinence surgery were slightly more likely to voice more voiding complaints than were other women in the study, but the increases were not statistically significant.

"It was really quite surprising to see how common voiding complaints were," said lead author Peggy Norton, MD, of the University of Utah School of Medicine, Salt Lake City. "We had people complaining of having to press on their bladder, having to bend over to urinate, complaining that their stream was abnormal in some way. We had expected quite the opposite."

For now, Dr. Norton said, clinicians do not have a clear-cut, reliable method for determining which patients are at highest risk for voiding symptoms. Two-year outcomes data from SISTEr may offer more guidance.