Document Type : Research articles


Gynecology and Obstetrics Department, Mahdieh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Background: Urinary incontinence (UI) may be associated with symptoms of overactive bladder (OAB) that may persist after anti-incontinence surgery.Objectives: The present study was performed to evaluate the effect of prolapse and anti-incontinence reconstructive surgery in women who had the symptoms of OAB and UI at the same time.Methods: This descriptive cross-sectional study was performed on 56 women with OAB symptoms and stress UI (SUI)/urgency UI (UUI) with or without prolapse who were candidates for restorative and anti-incontinence surgery. At baseline, urinary symptoms, including urinary frequency, nocturia, SUI, and UUI, were recorded. Patients who finally underwent vaginal reconstructive surgery with anti-incontinence surgery were assessed for urinary symptoms six months after the operation.Results: A total of 28 patients underwent transobturator tape (TOT) surgery, of whom 23 patients were subjected to other anti-incontinence surgeries and 5 patients underwent restorative surgeries. There was no significant difference between the two groups (TOT and others) in terms of age, body mass index, number of deliveries, history of medical problems, and history of surgery or cesarean section. The urinary frequency and nocturia before surgery were observed in 46 (82%) and 20 (36%) patients, respectively, which were not significantly different between the two groups. Before the study, occult UI was observed in 2 patients (4%), UUI in 3 patients (5%), SUI in 18 patients (32%), and mixed UI in 33 patients (59%). Nocturia was completely improved in all 20 patients. Urinary frequency was partially or completely improved in 41 patients (89%), which was not significantly different between the two groups (P=0.051). Overall, 53 patients (95%) had partial or complete improvement in UI, which was not significantly different between the two groups (P=0.058). Both patients with occult UI and all three patients with UUI were completely improved. Sixteen out of 18 patients (89%) with SUI were completely improved and the other 2 patients were partially improved. Thirty patients (91%) with mixed UI had a complete or partial recovery that was not significantly different between the two groups (P=0.137).Conclusion: The findings of the present study showed that six months after anti-incontinence or reconstructive surgery, nocturia in all patients and urinary frequency in 89% of patients improved partially or completely. Various forms of UI partially or completely improved in 95% of patients, as well.


  1. Irwin GM. Urinary Incontinence. Prim Care. 2019;46:233-42. doi: 10.1016/j.pop.2019.02.004.
  2. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An international urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for female pelvic floor dysfunction: Terminology for Female Pelvic Floor Dysfunction. Neurourol Urodyn. 2010;29:4-20. doi: 10.1002/nau.20798. [PubMed: 19937315]
  3. Ouslander JG. Management of Overactive Bladder. N Engl J Med. 2004;350:786-99. doi: 10.1056/NEJMra032662. [PubMed: 14973214]
  4. Homma Y, Yoshida M, Seki N, Yokoyama O, Kakizaki H, Gotoh M, et al. Symptom assessment tool for overactive bladder syndrome—overactive bladder symptom score. Urol. 2006;68:318-23. doi: 10.1016/j.urology.2006.02.042. [PubMed: 16904444]
  5. Stewart W, Van Rooyen J, Cundiff G, Abrams P, Herzog A, Corey R, et al. Prevalence and burden of overactive bladder in the United States. World J Urol. 2003;20:327-36. doi: 10.1007/s00345-002-0301-4. [PubMed: 12811491]
  6. Serati M, Salvatore S, Uccella S, Artibani W, Novara G, Cardozo L, et al. Surgical treatment for female stress urinary incontinence: what is the gold-standard procedure?. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:619-21. doi: 10.1007/s00192-009-0850-9. [PubMed: 19271091]
  7. Serati M, Bauer R, Cornu JN, Cattoni E, Braga A, Siesto G, et al. TVT-O for the treatment of pure urodynamic stress incontinence: efficacy, adverse effects, and prognostic factors at 5-year follow-up. Eur Urol. 2013;63:872-8. doi: 10.1016/j.eururo.2012.12.022. [PubMed:23274106]
  8. Serati M, Ghezzi F, Cattoni E, Braga A, Siesto G, Torella M, et al. Tension-free vaginal tape for the treatment of urodynamic stress incontinence: efficacy and adverse effects at 10-year follow-up. Eur Urol. 2012;61:939-46. doi: 10.1016/j.eururo.2012.01.038. [PubMed: 22305110].
  9. Tahseen S, Reid P. Effect of transobturator tape on overactive bladder symptoms and urge urinary incontinence in women with mixed urinary incontinence. Obstet Gynecol. 2009;113:617-23. doi: 10.1097/AOG.0b013e31819639e3. [PubMed: 19300325]
  10. Katsumi HK, Rutman MP. Can we predict if overactive bladder symptoms will resolve after sling surgery in women with mixed urinary incontinence?. Curr Urol Rep. 2010;11:328-37. doi: 10.1007/s11934-010-0133-5. [PubMed: 20632135]
  11. Liang CC, Hsieh WC, Huang L. Outcome of coexistent overactive bladder symptoms in women with urodynamic urinary incontinence following anti-incontinence surgery. Int
  12. Urogynecol J. 2017;28:605-11. doi: 10.1007/s00192-016-3153-y.
  13. Digesu GA, Salvatore S, Chaliha C, Athanasiou S, Milani R, Khullar V. Do overactive bladder symptoms improve after repair of anterior vaginal wall prolapse?. Int Urogynecol J. 2007;18:1439-43. doi: 10.1007/s00192-007-0375-z. [PubMed: 17429557]
  14. Rogowski A, Bienkowski P, Tosiak A, Jerzak M, Mierzejewski P, Baranowski W. Mesh retraction correlates with vaginal pain and overactive bladder symptoms after anterior vaginal mesh repair. Int Urogynecol J. 2013;24:2087-92. doi: 10.1007/s00192-013-2131-x. [PubMed: 23749240].