The emperor has no clothes: OAB can be cured surgically

Author:

Petros PeterORCID

Abstract

AbstractThe paper by Karjalainen et al., who reviewed 2,933 pelvic organ prolapse surgeries, showed 75% cure for “bothersome” urge urinary incontinence (UUI), is more than an “Aha” moment; it is an “Emperor has no clothes” moment. Since 1976, a convention of “no surgery” for women with UUI (now overactive bladder, OAB) has become almost an article of faith. Yet, surgical cure of OAB has been known since 1997, when this journal published the first urodynamically controlled study with 20-month data: 86% cure for UUI, 85% for frequency, 80% for nocturia following pubourethral ligament (PUL) and uterosacral ligament (USL) sling repair in 85 women. This study was followed by many other publications over the years recording OAB cure. It is not that even a small fraction of the 600 million women on the planet will now undergo surgery, or that damaged ligaments are the only cause of OAB. However, knowing OAB can be cured opens the door for young creative minds to bring hope and relief to these women non-surgically, as well as surgically.

Funder

University of Western Australia

Publisher

Springer Science and Business Media LLC

Subject

Urology,Obstetrics and Gynecology

Reference6 articles.

1. Bates P, Bradley WE, Glen E, et al. International Continence Society, first report on the standardisation of terminology of lower urinary tract function. Br J Urol. 1976;48:39–42.

2. Koelbl H, Igawa TY, Salvatore S, et al. Pathophysiology of urinary incontinence, faecal incontinence and pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A, editors. Fifth international consultation on incontinence. Bristol: International Consultation on Urological Diseases; 2013. p. 261–360.

3. Karjalainen PK, Tolppanen AM, Mattsson NK, et al. Pelvic organ prolapse surgery and overactive bladder symptoms—a population-based cohort (FINPOP). Int Urogynecol J. 2022;33:95–105. https://doi.org/10.1007/s00192-021-04920-w.

4. Petros PE. New ambulatory surgical methods using an anatomical classification of urinary dysfunction improve stress, urge, and abnormal emptying. Int Urogynecol J. 1997;8(5):270–8.

5. Shkarupa D, Zaytseva A, Kubin N, Kovalev G, Shapovalova E. Native tissue repair of cardinal/uterosacral ligaments cures overactive bladder and prolapse, but only in pre-menopausal women. Cent European J Urol. 2021;74:379–81.

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1. Reply to “The emperor has no clothes: OAB can be cured surgically”;International Urogynecology Journal;2022-07-22

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