1. Incidence of Stress Urinary Incontinence following Surgical Repair of Pelvic Organ Prolapse in Previously Continent Women Incidence of Stress Urinary Incontinence following Surgical Repair of Pelvic Organ Prolapse in Previously Continent Women Hazem Al-Mandeel, MD; Magali Robert, MD; Sue Ross, PhD Division of Urogynecology and Pelvic Reconstructive Surgery. Department of Obstetrics and Gynecology Background: pelvic organ prolapse (POP) and stress urinary incontinence (SUI) occurs in up to 50% of parous women. Patients with POP commonly suffer from SUI. Even continent women with POP may have "occult" SUI. According to the literature, 36% to 80% of women with an advanced degree of POP have occult SUI and at risk of developing postoperative SUI after POP repair. There is limited evidence of the incidence of postoperative SUI in women who did not have occult SUI diagnosed preoperatively and did not undergo anti-incontinence surgery with their POP repair. A recent study of 68 women reported only 2% of postoperative SUI, which is lower than what is expected. Objective: our aim is to determine the incidence of postoperative SUI in previously continent women who have undergone reconstructive repair of various types and degrees of POP without a concomitant anti-incontinence procedure. The study will also, assess the quality of life of those patients who developed postoperative SUI, to understand the bothersome effect and the impact of this problem on those women. Study Method: all women who underwent reconstructive vaginal surgery for POP without any combined anti-incontinence procedure, within the last two years done at Foothills Hospital or Grace Women's Health Centre by an Urogynecologist, will be eligible. Exclusion criteria will include all patients who had SUI before or during the preoperative assessment, and those who had any type of anti-incontinence surgery in the past. Other exclusion criteria will be those who had an abdominal surgery or obliterative vaginal surgery to treat their prolapse. All eligible women will receive a mailed questionnaire. For women who return the questionnaire, preoperative, operative, and postoperative details will be collected from their hospital charts. The questionnaire will involve determining questions about a postoperative onset of urinary incontinence focusing on SUI. Other questions will include if the problem is bothersome and the use of Incontinence Impact Questionnaire (IIQ-7). Value of the Study: our study will provide useful information for gynecologists and urologists in counseling women about the estimated risk of developing postoperative SUI following POP repair surgery. In addition, it will enable us to decide whether there is a problem to be investigated further: if so, the study will provide basic information on which to base the sample size calculation for a prospective study. References: 1 Richardson DA, Bent AE, Ostergard DR. 1983. The effect of uterovaginal prolapse on urethrovesical pressure dynamics. Am J Obstet Gynecol. 1983; 146: 901–905. 2. Bump RC, Fantl JA, Hurt WG. The mechanism of urinary continence in women with severe uterovaginal prolapse: results of barrier studies. Obstet Gynecol. 1988; 72:291–295 3. Rosenzweig BA, Pushkin S, Blumenfeld D, Bhatia NN. Prevalence of abnormal urodynamic test results in continent women with severe genitourinary prolapse. Obstet Gynecol. 1992; 79: 539–542. 4. Bergman A, Koonings PP, Ballard CA. Predicting postoperative urinary incontinence development in women undergoing operation for genitourinary prolapse. Am J Obstet Gynecol. 1988; 158: 1171-5 5. Kleeman S, Vassallo B, Segal J, Hungler M, Karram M. The ability of history and a negative cough stress test to detect occult stress incontinence in patients undergoing surgical repair of advanced pelvic organ prolapse. IUJ. 2006 Jan;17 (1):27-9.