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Purpose: The International Continence Society and the International Urogynecological Association have not yet standardized the definition of de novo stress urinary incontinence. Recent studies define the development of stress urinary incontinence as occurring after surgical repair of pelvic organ prolapse in previously continent women. The mechanisms that cause de novo stress urinary incontinence are not yet clear. Knowledge of the predictive factors for this outcome after surgical correction of pelvic organ prolapse would be useful for assessing whether a concomitant anti-incontinence procedure should be performed., Materials and Methods: The aim of this systematic review and meta-analysis was to identify some of the risk factors for de novo stress urinary incontinence: high body mass index, pelvic organ prolapse stage before surgery, presence of occult urinary incontinence, type of surgery, and the presence of diabetes mellitus. The present study was registered in the PROSPERO database under number CRD42021293764, and the systematic review was carried out according to the MOOSE recommendations and with the PRISMA 2020 guidelines., Results: A total of 2429 articles were identified. Nine cohort studies were included in the systematic review and seven in the meta-analysis. The risk of bias was assessed via the Newcastle-Ottawa scale and the certainty of evidence was assessed using the GRADE approach for each outcome. In the meta-analysis, associations were identified between de novo stress urinary incontinence and occult urinary incontinence (n: 422; OR: 2.01; 95% CI: 1.26-3.22; p = 0.004), diabetes (n: 1213; OR: 2.35; 95% CI: 1.30-4.26; p = 0.005), and advanced pelvic organ prolapse (n: 1003; OR: 1.94; 95% CI: 1.14-3.30; p = 0.01). Consulting a meta-analysis for the type of surgery was deemed impossible. A previous study comparing abdominal sacrocolpopexy with minimally invasive sacrocolpopexy revealed that women who underwent abdominal sacrocolpopexy were more likely to develop de novo stress urinary incontinence (n: 77; OR: 4.73; 95% CI: 1.56-14.34; p = 0.005). Another study found that pelvic organ prolapse repair using a transvaginal mesh was associated with higher levels of de novo stress urinary incontinence compared to robot-assisted sacrocolpopexy (n: 76; OR: 6.74; 95% CI: 1.35-33.75; p = 0.02). A meta-analysis of overweight or obesity was not possible due to the different assessment methods used in the studies., Conclusions: This meta-analysis revealed that occult incontinence, diabetes, and advanced pelvic organ prolapse before repair were associated with de novo stress urinary incontinence and these groups may therefore benefit from for anti-incontinence procedures concomitant with pelvic organ prolapse repair., (© 2024 Wiley Periodicals LLC.)

Objective: The aim of the current study was to perform the translation, cross-cultural adaptation and validation of the Underactive Bladder Questionnaire (UAB-q)., Methods: The study design included the Portuguese translation, cross-cultural adaptation and validation of the UAB-q in 90 patients from a urology outpatient clinic following international methodology. The psychometric properties tested were the validity, reliability, internal consistency and stability of the instrument., Results: The content validity index at the item (I-CVI) and scale level (S-CVI) were above 0.80 and did not require changes. Regarding the reliability analysis, Cronbach's alpha was 0.79. The internal consistency and the base time stability (test-retest) had excellent indexes; all were above 0.90., Conclusions: These results indicate that the UAB-q is a valid, reproducible and reliable instrument for screening underactive bladders and is a potentially useful tool to guide health actions and improve the care of underactive patients.

Introduction and Hypothesis: Our aim was to validate the Brazilian Portuguese version of the International Federation of Gynecology and Obstetrics (FIGO) Assessment Scoring System (FASS) to identify and quantify signs and symptoms related to pelvic floor dysfunction., Methods: One hundred and seventy-nine women aged 18-82 (47.68 ± 14.42) years participated in this validation study. Collected data included a sociodemographic and clinical questionnaire, application of the FASS, and physical examination using the Pelvic Prgan Prolapse Quantification (POP-Q) system. The translation and cross-cultural adaptation were performed following the international methodology. The psychometric properties tested were criterion validity, construct validity, stability, and reliability. For this purpose, the comparison with POP-Q findings and between symptomatic and asymptomatic patients, test-retest and internal consistency (Cronbach's alpha) were used, respectively. The intraclass correlation coefficient (ICC) was calculated to assess the level of agreement between evaluations (inter- and intraobservers). P < 0.05 was considered statistically significant., Results: The calculated Cronbach's alpha coefficient was 0.76, indicating strong reliability for the validation sample. Symptomatic women had different scores on all FASS items as well as total score when compared with asymptomatic women (p < 0.001). Intraobserver coefficient ranged from 0.91 (urinary symptoms) to 0.98 (FASS total score), indicating excellent concordance level in all items. Interobserver coefficient ranged from 0.47 (intestinal symptoms) to 0.90 (FASS total score), indicating moderate to excellent correlation., Conclusions: The psychometric properties tested in the FASS Portuguese version proved to be a valid and reliable for evaluating signs and symptoms related to pelvic floor function in Brazilian women.

Introduction and Hypothesis: Although still a matter of debate, stress urinary incontinence (SUI) may be accompanied by damage to urethral and pelvic floor innervations, thus promoting dysfunctions of the urethral support and sphincteric closure mechanisms. The aim of this study was to analyze the pelvic floor and urethral innervations through pelvic electrophysiological tests to identify whether neurological alterations interfere with urinary continence and urethral functional activity., Methods: This prospective study included 52 women, 33 with clinically and urodynamically proven SUI and 19 continent volunteers matched for age, height, parity, and number of vaginal deliveries by the propensity score method. The patients were divided according to the severity of urinary loss evaluated by measuring abdominal leak point pressure (ALPP). Pudendal nerve terminal motor latency (PNTML), pudendal somatosensory evoked potential (SSEP) latencies, urethral and clitoral sensory thresholds, and urethroanal reflex latency were tested., Results: SUI and control subjects did not differ in PNTML, SSEP latency, and clitoral sensory thresholds. However, reduced responsiveness to urethral electrosensitivity and prolonged urethroanal reflex latency were detected in most incontinent patients. In addition, urethral electrosensitivity was altered in suspected intrinsic sphincteric dysfunction., Conclusions: Urethral afferent pathways can be altered in women with SUI and may play an important role in evoking intrinsic sphincteric dysfunction.

Introduction and Hypothesis: The aim of this study is to validate the Portuguese translated version of the Prolapse Quality-of-Life Questionnaire (P-QoL)., Methods: Ninety-eight women completed the P-QoL questionnaire translated into Portuguese at baseline and on the second visit, 2 weeks later. Clinical data and Pelvic Organ Prolapse Quantification Index (POP-Q) according to the International Continence Society were obtained. Psychometric properties of the questionnaire were assessed., Results: Sixty-eight symptomatic and 30 asymptomatic women for POP symptoms were studied. Most patients presented POP-Q > 2. The P-QoL demonstrated good psychometric properties. The test-retest reliability confirmed a highly significant stability between the total scores for each domain (P < 0.0001). The construct validation distinguished differences in P-QoL questionnaire scores between symptomatic and asymptomatic women., Conclusion: The Portuguese version of the P-QoL questionnaire is a valid and reliable instrument to assess quality of life in Brazilian women with pelvic organ prolapse.