Ginecologia e Obstetrícia

Ginecologia e Obstetrícia
Acesso livre

ISSN: 2161-0932


De Novo Urgency: A Review of the Literature

Lleberia J, Pubill J, Mestre M, Aguilo O, Serra L and Canet Y

De novo urgency can be defined as the appearance of urge urinary incontinence after an anti-incontinence surgery that persists after six months. This term can only be used when the patient did not have any urgency preoperative symptoms. The incidence of de novo urgency varies between 3.1% and 25.9% and although its pathophysiology is unclear, it is suggested that an obstruction (absolute or relative) is caused during the procedure that induces a reaction in the detrussor muscle. The evaluation of de novo urgency includes a thorough anamnesis, physical examination, residual urine evaluation, urinalysis, and urodynamic testing. When there is evidence of a bladder outlet obstruction, its treatment is urethrolysis or urethral dilatation. For patients without obstruction, a more conservative approach including pelvic floor exercises and antimuscarinics is recommended. A meticulous surgical technique is the key to try preventing this pathology. As excellent practise for incontinence techniques cannot prevent all cases must continue deepen their study of anatomical and functional factors.