Can de novo XXXX after anterior wall repair be predicted?

@entity1 @entity3577 @entity322 @entity3142
OBJECTIVE: To locate preoperatively continent @entity1 with @entity3577 at risk of developing @entity322 after surgery by means of reducing the prolapse preoperatively with a speculum and a pessary. DESIGN: Prospective observational cohort study. SETTING: Departments of Obstetrics and Gynecology at Northern Alvborgs County Hospital, Varbergs Hospital, and Sahlgrenska University Hospital, Sweden, between 2000 and 2004. POPULATION: @entity1 scheduled for anterior wall repair with no history of @entity322 . METHODS: Data were collected using a questionnaire, a voiding diary, a gynecological examination including staging of prolapse with the Pelvic Organ Quantification System and clinical testing preoperatively and one year after vaginal repair. The first test included a cough test while the prolapse was reduced with a speculum. The second test was performed with the @entity1 undergoing a standardized quantification test and a 48-hour pad test after reducing the prolapse with a pessary. Postoperatively, clinical testing was repeated one year after surgery without any device in place. MAIN OUTCOME MEASURES: Reported symptoms of leakage during movement or coughing. RESULTS: Seventy-four @entity1 were included. Before surgery, six (8.1%) @entity1 tested positive during the speculum test and seven (9.5%) during the pessary test. Eight @entity1 (10.8%) were found to have subjective @entity3142 after 1 year. This was only confirmed in four @entity1 during stress testing. The positive predictive values for subjective @entity3142 of the speculum and the pessary tests were 42.9% (95%CI 12.0-76.9) and 33.3% (95%CI -4.4 to +71.5), respectively. The negative predictive values of the tests were 92.5% (95%CI 90.3-1.00) and 91.1% (95%CI 88.5-99.7). CONCLUSIONS: The tested preoperative methods predicting de novo subjective @entity3142 after anterior wall repair did not show sufficient positive predictive values to be clinically useful.
