Urinary symptoms and urodynamic findings before and after vaginal surgery for pelvic organ prolapse

Submitted: 27 November 2020
Accepted: 15 June 2021
Published: 30 June 2021
Abstract Views: 1541
PDF: 249
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

To ascertain the difference in urodynamic findings, specifically bladder sensation, and urinary symptoms after vaginal surgery for Pelvic Organ Prolapse (POP). Retrospective data analysis of 126 women who underwent vaginal surgery for POP without simultaneous anti-incontinence procedure from January 2013 to April 2019 at Siriraj Hospital, Thailand. Baseline characteristics, intraoperative details and pre and post-operative urinary symptoms and urodynamic findings were recorded. There was no significant difference in the pre and post-operative first desire to void, at 158±53 mL and 162±64 mL, respectively (p=0.518). Incidence of increased bladder sensation was also unchanged, from 46.0% to 46.8% (p=1.00). Post-operative urodynamic stress incontinence was significantly increased, from 15.9% to 31.0% (p=0.003), as was the incidence of weak bladder contractility index (<100), from 47.3% to 61.8% (p=0.005). Significant improvements in post-operative urge urinary incontinence, urgency and voiding dysfunction were noted, from 50.8% to 31.7% (p=0.001), 63.5% to 38.9% (p<0.001) and 42.9% to 5.6% (p<0.001), respectively. No significant difference in bladder sensation after vaginal surgery for POP repair was noted. However, urinary symptoms significantly improved after surgery.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Haylen BT, Maher CF, Barber MD, et al. An International Urogynecological Association (IUGA) / International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J 2016;27:165-94. DOI: https://doi.org/10.1007/s00192-015-2932-1
Jackson SL, Weber AM, Hull TL, et al. Fecal incontinence in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 1997;89:423-7. DOI: https://doi.org/10.1097/00006250-199703000-00021
Panicker R, Srinivas S. Urodynamic Changes in Pelvic Organ Prolapse and the Role of Surgery. Med J Armed Forces India 2009;65:221-24. DOI: https://doi.org/10.1016/S0377-1237(09)80007-5
Madhu CK, Hashim H. Surgery for pelvic organ prolapse. Eur Urol Suppl 2018;17:119-25. DOI: https://doi.org/10.1016/j.eursup.2018.01.002
Clark AL, Gregory T, Smith VJ, et al. Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 2003;189:1261-7. DOI: https://doi.org/10.1067/S0002-9378(03)00829-9
Brown JS, Waetjen LE, Subak LL, et al. Pelvic organ prolapse surgery in the United States, 1997. Am J Obstet Gynecol 2002;186:712-6. DOI: https://doi.org/10.1067/mob.2002.121897
Lensen EJM, Withagen MIJ, Kluivers KB, et al. Urinary incontinence after surgery for pelvic organ prolapse. Neurourol Urodyn 2013;32:455-9. DOI: https://doi.org/10.1002/nau.22327
Ugianskiene A, Kjargaard N, Lindquist ASI, et al. Retrospective study on de novo postoperative urinary incontinence after pelvic organ prolapse surgery. Eur J Obstet Gynecol Reprod Biol 2017;219:10-4. DOI: https://doi.org/10.1016/j.ejogrb.2017.10.002
Frigerio M, Manodoro S, Palmieri S, et al. Risk factors for stress urinary incontinence after native-tissue vaginal repair of pelvic organ prolapse. Int J Gynecol Obstet 2018;141:349-53. DOI: https://doi.org/10.1002/ijgo.12443
Alas AN, Chinthakanan O, Espaillat L, et al. De novo stress urinary incontinence after pelvic organ prolapse surgery in women without occult incontinence. Int Urogynecol J 2017;28:583-90. DOI: https://doi.org/10.1007/s00192-016-3149-7
Long CY, Hsu SC, Wu TP, et al. Urodynamic comparison of continent and incontinent women with severe uterovaginal prolapse. J Reprod Med 2004;49:33-7.
Richardson D, Bent A, Ostergard D. The effect of uterovaginal prolapse on urethrovesical pressure dynamics. Am J Obstet Gynecol 1983;146:901-5. DOI: https://doi.org/10.1016/0002-9378(83)90961-4
Bump RC, Fantl JA, Hurt WG. The mechanism of urinary continence in women with severe uterovaginal prolapse: results of barrier studies. Obstet Gynecol 1988;72:291-5.
Lo TS, Bt Karim N, Nawawi EA, et al. Predictors for de novo stress urinary incontinence following extensive pelvic reconstructive surgery. Int Urogynecol J 2015;26:1313-9. DOI: https://doi.org/10.1007/s00192-015-2685-x
Foster Sr RT, Barber MD, Parasio MF, et al. A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse. Am J Obstet Gynecol 2007;197:82.e1-4. DOI: https://doi.org/10.1016/j.ajog.2007.02.049
Illiano E, Natale F, Giannantoni A, et al. Urodynamic findings and functional outcomes after laparoscopic sacrocolpopexy for symptomatic pelvic organ prolapse. Int Urogynecol J 2019;30:589-94. DOI: https://doi.org/10.1007/s00192-019-03874-4
Abdullah B, Nomura J, Moriyama S, et al. Clinical and urodynamic assessment in patients with pelvic organ prolapse before and after laparoscopic sacrocolpopexy. Int Urogynecol J 2017;28:1543-9. DOI: https://doi.org/10.1007/s00192-017-3306-7
Kummeling MTM, Rietbergen JBW, Withagen MIJ, et al. Sequential urodynamic assessment before and after laparoscopic sacrocolpopexy. Acta Obstet Gynecol Scand 2013;92:172-7. DOI: https://doi.org/10.1111/aogs.12045
Haylen BT, de Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 2010;29:4-20. DOI: https://doi.org/10.1002/nau.20798
Drake MJ, Doumouchtsis SK, Hashim H, et al. Fundamentals of urodynamic practice, based on International Continence Society good urodynamic practices recommendations. Neurourol Urodyn 2018;37:S50-60. DOI: https://doi.org/10.1002/nau.23773
Yao M, Simoes A. Urodynamic Testing and Interpretation. [Updated 2020 Sep 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562310/
Blaivas JG, Groutz A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn 2000;19:553-64. DOI: https://doi.org/10.1002/1520-6777(2000)19:5<553::AID-NAU2>3.0.CO;2-B
Nitti VW. Pressure flow urodynamic studies: the gold standard for diagnosing bladder outlet obstruction. Rev Urol 2005;7:S14-21.
Barber MD, Brubaker L, Nygaard I, et al. Defining success after surgery for pelvic organ prolapse. Obstet Gynecol 2009;114:600-9. DOI: https://doi.org/10.1097/AOG.0b013e3181b2b1ae
Siroky MB. The aging bladder. Rev Urol 2004;6:S3-7.
Boer TA, Salvatore S, Cardozo L, et al. Pelvic organ prolapse and overactive bladder. Neurourol Urodyn 2010;29:30–9. DOI: https://doi.org/10.1002/nau.20858
Romanzi LJ, Chaikin DC, Blaivas JG. The effect of genital prolapse on voiding. J Urol 1999;161:581–6. DOI: https://doi.org/10.1016/S0022-5347(01)61957-8
Miyazato M, Yoshimura N, Chancellor MB. The other bladder syndrome: underactive bladder. Rev Urol 2013;15:11-22.

How to Cite

Srikureja, N., Hengrasmee, P., Leerasiri, P., & Asumpinwong, C. (2021). Urinary symptoms and urodynamic findings before and after vaginal surgery for pelvic organ prolapse. Urogynaecologia, 33(1). https://doi.org/10.4081/uij.2021.264