INTRODUCTION: We aimed to assess the predictivity of preoperative urodynamics (UDS) on de novo stress urinary incontinence (SUI) in patients having advanced pelvic organ prolapse (POP). METHODS: Between January 2016 and June 2019, 133 patients with symptomatic POP at stage 3 or higher were included in the study. The presence of postoperative SUI symptoms after a minimum of six months of followup was considered the primary outcome. The results of all patients' preoperative UDS were compared to their postoperative SUI symptoms. In addition, patients were divided into two groups based on whether SUI was detected during preoperative UDS testing (group 1) or not (group 2). RESULTS: Although preoperative measurements, such as bladder capacity and residual urine volume, were not different between groups, group 1 had lower maximal urethral closure pressures (p=0.002). Preoperative SUI symptoms had a sensitivity of 32.1% and a specificity of 91.4% for predicting de novo SUI. In patients with advanced POP, preoperative UDS had a sensitivity of 60.7% and a specificity of 87.6% for predicting de novo SUI. CONCLUSIONS: Urodynamic examination with a pessary can significantly predict the development of de novo SUI.