Incontinence & Female Urology & Neurourology(구연) (NP-048) 내인성 요도괄약근 기능부전으로 인한 여성요실금 환자에서 Remeex 수술 후에 발생하는 과민성방광증상에 대한 예측 인자 차의과대학교 비뇨기과학교실 이승렬, 노주현, 김대근, 김태헌, 유영동, 홍영권 Objectives: To evaluate non-invasive clinical and urodynamic parameters for the prediction of overactive bladder (OAB) in stress urinary incontinence (SUI) women with intrinsic sphincter deficiency (ISD) following a readjustable mid-urethral sling surgery (Remeex system). Methods: We retrospectively reviewed the records of 130 women with SUI due to ISD who underwent a Remeex system between February 2011 and March 2017. ISD was defined as a Valsalva leak point pressure (VLPP) of less than 60 cmH2O. The women with SUI were classified according to presence of OAB symptom before and 6 months after a Remeex system into one of the following four groups: women without preoperative and postoperative OAB (Group 1, n=46), women without preoperative OAB and with postoperative OAB (Group 2, n=15), women with preoperative OAB and without postoperative OAB (Group 3, n=25), and women with preoperative and postoperative OAB (Group 4, n=44). Clinical and urodynamic factors were evaluated as predictors of de novo OAB. Results: There were significant differences among the four groups with respect to age (p=0.036), 1 month-postoperative peak urinary flow rate (PUFR, p=0.001), 1 month-postoperative residual urine volume (RUV, p=0.005). But, there were no significant differences among the four groups with respect to body mass index, diabetes, multiparity, menopause, previous hysterectomy, previous incontinence surgery, previous pelvic organ prolapse surgery, pyuria, preoperative PUFR, preoperative RUV, maximal cystometric capacity, VLPP, MUCP, detrusor pressure at PUFR, and detrusor overactivity (p>0.05). The 1-month postoperative PUFR decreased significantly compared with preoperative PUFR in group 1, 2, and 4 (p=0.002, p=0.001, and p=0.001, respectively). Pair wise comparisons regarding age, 1 month-postoperative PUFR, and 1 month-postoperative RUV demonstrated that there were statistically significant differences of 1 month-postoperative PUFR and RUV between group 2 and other groups (p<0.0125). Multivariate logistic regression analyses revealed that the only 1 month-postoperative PUFR was a significant predictor of de novo OAB after a Remeex system (odds ratio = 0.823, 95% confidence interval = 0.727-0.931, p=0.002). Conclusions: A decrease in PUFR after a Remeex system represents a promising metric to screen for de novo OAB that is noninvasive and easy to perform. keywords : stress incontinence, intrinsic sphincter deficiency, anti-incontinence surgery