Incontinence and detrusor dysfunction associated with pelvic organ prolapse: clinical value of preoperative urodynamic evaluation

Int Urogynecol J Pelvic Floor Dysfunct. 2009 Nov;20(11):1301-6. doi: 10.1007/s00192-009-0954-2. Epub 2009 Jul 14.

Abstract

Introduction and hypothesis: We examined how preoperative urodynamic findings are related to the urinary problems following surgical repair of pelvic organ prolapse (POP).

Methods: The clinical records of 87 women who underwent surgery for POP were reviewed retrospectively. Preoperatively, cough stress test and urodynamic testing, including pressure-flow study, were performed with prolapse reduction. Postoperative evaluation included uroflowmetry, postvoid residuals, and symptom assessment using questionnaires.

Results: A cough stress test with simple filling was sufficient for diagnosis of occult stress urinary incontinence (SUI). The presence of detrusor overactivity was a good predictor of postoperative persistence of urgency and urge urinary incontinence. Postvoid residuals (PVR) largely increased immediately after surgery, but usually recovered within 1 month. Poor detrusor contractility was the best predictor of large PVR occurrence.

Conclusions: Preoperative urodynamic evaluation of SUI and detrusor function was useful for predicting postoperative urinary conditions in POP patients. Its cost-effectiveness remains to be examined.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cough
  • Female
  • Follow-Up Studies
  • Health Surveys
  • Humans
  • Middle Aged
  • Pelvic Organ Prolapse / complications
  • Pelvic Organ Prolapse / physiopathology*
  • Pelvic Organ Prolapse / surgery*
  • Postoperative Period
  • Predictive Value of Tests
  • Preoperative Period*
  • Retrospective Studies
  • Urinary Bladder, Overactive / etiology
  • Urinary Bladder, Overactive / physiopathology*
  • Urinary Incontinence, Stress / etiology
  • Urinary Incontinence, Stress / physiopathology*
  • Urodynamics / physiology