Factors associated with urge urinary incontinence after surgery for stress urinary incontinence

Objective: The objectives of the study were to estimate the severity of urge urinary incontinence (UUI) after surgery for stress incontinence and identify factors associated with symptom severity. Methods: Four hundred thirty-eight women who underwent surgery for stress incontinence over a 10-year period completed a mailed questionnaire protocol that included validated instruments to assess lower urinary tract function and mental and physical well-being. Bivariate analysis and generalized linear models were used to identify factors associated with severity of UUI as measured by the urge incontinence domain of the Incontinence Symptom Index. Results: Urge urinary incontinence was experienced daily by 35.9% of patients. Factors independently associated with higher UUI severity scores were preoperative mixed urinary incontinence (P = 0.006), depression (P < 0.001), aging (P < 0.001), and longer follow-up times (P = 0.01). Pubovaginal sling (P = 0.001) and urethral vaginal suspension (P = 0.04) had higher severity scores than Tension-Free Vaginal Tape. Conclusions: Daily episodes of UUI are experienced by slightly more than one third of women after surgery for stress incontinence. Identification of factors associated with UUI may help physicians to modify treatment and patient expectations.