Predictive factors for overactive bladder symptoms after pelvic organ prolapse surgery (original) (raw)
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The surgical effect on overactive bladder symptoms in women with pelvic organ prolapse
Scientific Reports, 2021
This study aimed to explore the effect of pelvic reconstruction surgery on the relation of pelvic organ prolapse (POP) and overactive bladder (OAB) and the impact of preoperative vaginal oestrogen supplement on vaginal tissue. A total of 100 postmenopausal women with symptomatic POP who underwent pelvic reconstruction surgery (laparoscopic sacrocolpopexy or transvaginal mesh) were enrolled in this study. Preoperative vaginal oestrogen was prescribed in 28 cases. The evaluation tools consisted of POP-Q, urodynamic study, Overactive Bladder Symptom Score (OABSS), and urinary NGF. Vaginal maturation index and vaginal specimens for hormone receptors study were investigated during operation to evaluate the effect of topical oestrogen. Follow-up assessments were performed at 1, 3, and 6 months after surgery. Preoperatively, 58 (58%) were POP with OAB. After reconstruction surgery, the OABSS decreased significantly (6.87 ± 0.85 vs 3.77 ± 0.61, p < 0.001) at postoperative 6 months in the...
International Urogynecology Journal, 2011
Introduction and hypothesis The aim of this study was to identify the predictors of improved overactive bladder (OAB) symptoms after transvaginal mesh repair. Methods Eighty women with pelvic organ prolapse (POP) stage II to IV reporting OAB symptoms were scheduled for transvaginal mesh procedures. Preoperative and postoperative assessments included a bladder diary, urodynamics, and a personal interview about urinary symptoms. Results Sixty-three (78.8%) women experienced improvement of OAB symptoms (Improvement group), and 17 (21.2%) women remained unchanged or worsened (Persis-tence group) postoperatively. A univariate analysis of patients' characteristics showed no difference between two groups regarding parity, diabetes, hypertension, prolapse status, preoperative urodynamic parameters, and urinary symptoms (P>0.05). However, the age (P=0.042) and preoperative detrusor overactivity (DO) (P=0.03) were two significant predictors of postoperative OAB improvement. Conclusions Women with POP may experience improvement of their OAB symptoms after transvaginal mesh repair. Both age and DO were two predictors in our univariate analysis, and the latter was the only significant predictor of symptom relief after adjusting age factor. Cheng-Yu Long and Chun-Shuo Hsu has contributed equally to this work.
Pelvic organ prolapse surgery and overactive bladder symptoms—a population-based cohort (FINPOP)
International Urogynecology Journal, 2021
Introduction and hypothesis It is unclear how compartment of pelvic organ prolapse (POP) impacts overactive bladder (OAB) symptom severity or improvement after POP surgery. We hypothesized that anterior and apical prolapse are more strongly associated with OAB symptoms than posterior compartment prolapse. Methods A total of 2933 POP surgeries from a prospective population-based cohort were divided into two groups: (1) anterior and/or apical compartment surgery (± posterior repair), N = 2091; (2) posterior repair only, N = 478. Urinary frequency and urgency urinary incontinence (UUI) were evaluated using PFDI-20 (bothersome symptom: score 3–4) at baseline, 6, and 24 months. Association between degree of POP in specific compartments and symptoms at baseline was estimated with generalized linear models and between compartment of surgery and symptom improvement with generalized estimating equations. Results At least one bothersome symptom was reported by 40% at baseline, 14% at 6, and 1...
Pakistan Journal of Medical Sciences, 2021
Objectives: This study asseses the association of overactive bladder symptoms and pelvic organ prolapse severity and evaluates the effect of pelvic reconstructive surgery on overactive bladder (OAB) symptoms in women with pelvic organ prolapse (POP). It also looks into any pre and post-operative factors responsible for persistent postoperative OAB symptoms. Methods: This was a retrospective cross-sectional study conducted at the Aga Khan University Hospital, Karachi between 1st January 2014 and 31st December 2018. In this study women presenting with POP and concommitent OAB who underwent surgery for site specific defects, measured using Pelvic Organ Prolapse Quantification (POP-Q) staging system. OAB was defined as presence of urinary frequency, urinary urgency incontinence (UUI) and an affirmative response to item #15 and/or item #16 of the Pelvic Floor Distress Inventory (PFDI), which was used both pre and postoperatively. Primary outcome of the study was to find complete resoluti...
Urinary symptoms and urodynamic findings before and after vaginal surgery for pelvic organ prolapse
Urogynaecologia, 2021
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 ...
BJU International, 2018
Objective The objective of this interventional study was to examine extent and intensity of the coexistence of overactive bladder (OAB) symptoms in women with pelvic organ prolapse (POP) and to evaluate the likelihood of OAB symptom improvement after surgical POP reconstruction in a period of two years. Patients and Methods The effectiveness of the transvaginal, single-incision Elevate@ technique for anatomical cure of anterior/apical and posterior/apical vaginal prolapse has been previously reported following a prospective, multicenter study. This technique utilizes mesh arms attached to the sacrospinous ligaments to recreate apical ligamentous support. Using the same sample population from the multicenter study (n=281), this sub-analysis focuses on estimating the extent of comorbidity between POP and OAB symptoms, as well as the effects of subsequent pelvic floor reconstruction on OAB symptoms in a long duration. Assessments of POP and OAB symptom severity before and after surgery at 6, 12 and 24 months were obtained with the pelvic floor distress inventory (PFDI) questionnaire. Results Preoperatively, 70% of all POP patients reported OAB moderate to severe symptoms, with almost half (49.5%) noting severe OAB bother ("quite a bit") of one or more of the classic OAB symptom domains on the PFDI: "daytime urinary frequency", "urinary urgency", "urinary urgency incontinence", and/or "nocturia". In fact, across all 4 OAB symptom domains evaluated, there were significantly more severe ("quite a Accepted Article This article is protected by copyright. All rights reserved. bit") symptoms than moderate ("moderately") or mild ("somewhat"); 26-31%, 13-21%, and 17-19%, respectively. In patients with symptomatic POP > Stage 2, there was no relationship between further degree of prolapse and presence of severity of OAB symptoms. However, patients with POP Stage 2 versus Stage 3-4 had significantly more complaints regarding the items "daytime urinary frequency" and "urinary urgency incontinence". Pelvic floor reconstructive surgery resulted in a significant improvement of all OAB symptoms that seems to be stable over time. The cure rate of moderate-to-severe OAB complaints ranged between 60-80%, which was a durable improvement noted throughout 24 months. Conclusion POP is to a high degree accompanied with moderate-to-severe OAB complaints.
Pelvic organ prolapse and overactive bladder
Neurourology and Urodynamics, 2010
In this review we try to shed light on the following questions:. How frequently are symptoms of overactive bladder (OAB) and is detrusor overactivity (DO) present in patients with pelvic organ prolapse (POP) and is there a difference from women without POP?. Does the presence of OAB symptoms depend on the prolapsed compartment and/or stage of the prolapse?. What is the possible pathophysiology of OAB in POP?. Do OAB symptoms and DO change after conservative or surgical treatment of POP? Methods: We searched on Medline and Embase for relevant studies. We only included studies in which actual data about OAB symptoms were available. All data for prolapse surgery were without the results of concomitant stress urinary incontinence (SUI) surgery. Results: Community-and hospital-based studies showed that the prevalence of OAB symptoms was greater in patients with POP than without POP. No evidence was found for a relationship between the compartment or stage of the prolapse and the presence of OAB symptoms. All treatments for POP (surgery, pessaries) resulted in an improvement in OAB symptoms. It is unclear what predicts whether OAB symptoms disappear or not. When there is concomitant DO and POP, following POP surgery DO disappear in a proportion of the patients. Bladder outlet obstruction is likely to be the most important mechanism by which POP induces OAB symptoms and DO signs. However, several other mechanisms might also play a role. Conclusions: There are strong indications that there is a causal relationship between OAB and POP.
International Journal of Urology, 2014
HRQL = health-related quality of life ICIQ-SF = International Consultation on Incontinence Questionnaires Short Form IPSS = International Prostate Symptom Score LUTS = lower urinary tract symptoms MFR = maximal flow rate OAB-Q = overactive bladder questionnaire POP = pelvic organ prolapse POP-Q = pelvic organ prolapse quantification PVR = postvoid residual QOL = quality of life SUI = stress urinary incontinence TOT = transobturator tape TVM = tension-free vaginal mesh Correspondence: Satoru
Incidence and Management of De Novo Lower Urinary Tract Symptoms After Pelvic Organ Prolapse Repair
Current Urology Reports, 2017
Purpose of review Pelvic organ prolapse (POP) is a significant problem with many options for surgical correction. Following prolapse surgery, de novo lower urinary tract symptoms (LUTS) are not uncommon. We review the current literature on de novo lower urinary tract symptoms following POP repair and discuss the role of urodynamics in the evaluation of the prolapse patient. Recent findings Patients with occult stress urinary incontinence (SUI) appear to be at higher risk of developing de novo SUI after POP repair. Prolapse reduction in patients undergoing urodynamic evaluation is important. Different types of POP repair influence rates of de novo SUI. Also, prophylactic antiincontinence procedures at time of POP repair appear to lower the incidence of de novo SUI, but at the cost of increased risk of complications and morbidity. Pre-existing overactive bladder (OAB) symptoms may either improve or persist, and de novo OAB can develop. The specific role of urodynamic study testing for POP is still being determined. Summary Increasingly, women are seeking surgical treatment for POP. Aside from complications related to surgery in general, proper patient counseling is important regarding the risk of development of de novo voiding problems following surgery. Despite a growing body of literature looking at de novo voiding symptoms after prolapse repair, more studies are still needed.