Is there a pelvic organ prolapse threshold that predicts bladder outflow obstruction?

Int Urogynecol J. 2011 Jul;22(7):863-8. doi: 10.1007/s00192-011-1373-8. Epub 2011 Feb 22.

Abstract

Introduction and hypothesis: To determine if there is a cutpoint of anterior vaginal wall prolapse which predicts bladder outflow obstruction.

Methods: Subjects with and without bladder outflow obstruction (BOO) were identified. Baseline characteristics, urodynamics, and exam findings were compared.

Results: Forty-seven women with BOO were compared to 115 women without BOO. Those with obstruction were significantly older (53.9 vs. 50.0 years, p = 0.015) had higher parity (p = 0.03), significantly smaller maximum bladder capacity (359.0 vs. 426.0 ml, p < 0.0001), and were less likely to leak at smaller volumes (213.0 vs. 109.0 ml, p = 0.006) than those without obstruction. Those with obstruction also had higher measurements on Aa (p = 0.004) and Ba (p = 0.001), though receiver operator curve analysis did not reveal a clear point of anterior prolapse at which bladder outflow obstruction occurs.

Conclusions: Bladder outflow obstruction is associated with anterior vaginal wall prolapse, though there is no clear cutpoint of anterior prolapse which predicts obstruction.

MeSH terms

  • Female
  • Humans
  • Middle Aged
  • Organ Size
  • Pelvic Organ Prolapse / complications*
  • Pelvic Organ Prolapse / pathology*
  • Predictive Value of Tests
  • ROC Curve
  • Retrospective Studies
  • Urinary Bladder / pathology*
  • Urinary Bladder Neck Obstruction / etiology*
  • Urodynamics*