Detrusor underactivity in pelvic organ prolapse

Frigerio, Matteo; Manodoro, Stefano; Cola, Alice; Palmieri, Stefania; Spelzini, Federico; Milani, Rodolfo

doi:10.1007/s00192-017-3532-z

Cited by 42 publications

(49 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These women with DU, not surprisingly, had higher PVRs and voiding symptoms, but lower rates of UUI and DO, and greater anterior compartment descent. After POP repair, women both with DU and without had similarly improved voiding symptoms, suggesting that the women with DU actually had BOO relief as the mechanism for their improvement [42].…”

Section: Dumentioning

confidence: 93%

Systematic review of lower urinary tract symptoms occurring with pelvic organ prolapse

Cameron

2019

Arab Journal of Urology

View full text Add to dashboard Cite

Objective: To review lower urinary tract symptoms (LUTS), which include a large variety of bladder complaints, in women with simultaneous pelvic organ prolapse (POP). Methods: This article is a systematic review of the current literature on LUTS occurring simultaneously with POP following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Results: The prevalence of both conditions is high, but they occur more frequently together than can be explained by chance. It appears that POP is in some women causative of overactive bladder (OAB) symptoms, as in many women correction of the POP resolves the bladder symptoms and small studies of women with detrusor underactivity also demonstrate resolution of symptoms. The most plausible explanation for the relationship is that POP causes bladder outlet obstruction, which results in excess bladder irritability or poor contractility. However, not all women have resolution of their OAB symptoms and some women develop them de novo after POP repair, so this explanation requires more in depth study. Conclusions: Women with both LUTS and symptomatic POP should probably have their POP targeted, as its reduction either via surgery or pessary can correct the LUTS. However, no studies have addressed asymptomatic POP, so it is unclear if treating POP in these instances is of benefit.

show abstract

Section: Dumentioning

confidence: 93%

Systematic review of lower urinary tract symptoms occurring with pelvic organ prolapse

Cameron

2019

Arab Journal of Urology

View full text Add to dashboard Cite

show abstract

“…[7][8][9] Stress urinary incontinence is common in cases of mild pelvic organ prolapse, whereas urgency urinary incontinence, urinary urgency, and voiding symptoms are common in cases of moderate or severe pelvic organ prolapse (Level 3). 1,10,11 CQ8. How do FLUTS affect sexual function?…”

Section: Selected Cqsmentioning

confidence: 99%

Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition)

Takahashi¹,

Takei²,

Asakura³

et al. 2021

Int J of Urology

View full text Add to dashboard Cite

The present article is an abridged English translation of the Japanese Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition), published in September 2019. These guidelines consist of a total of 212 pages and are unique worldwide in that they cover female lower urinary tract symptoms other than urinary incontinence. They contain two algorithms for "primary treatment" and "specialized treatment," respectively. These guidelines, consisting of six chapters, address a total of 26 clinical questions including: (i) treatment algorithms; (ii) what are female lower urinary tract symptoms?; (iii) epidemiology and quality of life; (iv) pathology and illness; (v) diagnosis; and (vi) treatment. When the patient's symptoms mainly involve voiding and post-micturition symptoms, specialized treatment should be considered. In the event of voiding symptoms concurrent with storage symptoms, residual urine should be measured; if the residual urine volume is <100 mL, then diagnosis and treatment for storage symptoms is prioritized, and if the volume is ≥100 mL, then specialized treatment should be considered. When storage symptoms are the primary condition, then the patient is subject to the primary treatment algorithm. Specialized treatment for refractory overactive bladder includes botulinum toxin injection and sacral nerve stimulation. For stress urinary incontinence, surgical treatment is indicated, such as urethral slings. The two causes of voiding symptoms and post-micturition symptoms are lower urinary tract obstruction and detrusor underactivity (underactive bladder). Mechanical lower urinary tract obstruction, such as pelvic organ prolapse, is expected to improve with surgery.

show abstract

“…In patients bothered by lower urinary tract symptoms, DU can be identified in about 13% of women [7]. However, in specific populations, such as in women with advanced pelvic organ prolapse, the prevalence may increase up to 40% [9].…”

Section: Introductionmentioning

confidence: 99%

Detrusor underactivity prevalence and risk factors according to different definitions in women attending urogynecology clinic

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction and hypothesis There is still no consensus on definitions of detrusor underactivity; therefore, it is difficult to estimate the prevalence. The primary objective of the study was to evaluate the prevalence of detrusor underactivity in a cohort of patients with pelvic floor disorders according to different proposed urodynamics definitions. The secondary objectives were to estimate the association between detrusor underactivity and symptoms, anatomy and urodynamic findings and to build predictive models. Methods Patients who performed urodynamic evaluation for pelvic floor disorders between 2008 and 2016 were retrospectively analyzed. Detrusor underactivity was evaluated according to Schafer’s detrusor factor, Abrams’ bladder contractility index and Jeong cut-offs. The degree of concordance between each method was measured with Cohenʼs kappa, and differences were tested using Student’s t test, Wilcoxon test and Pearson’s chi-squared test. Results The prevalence of detrusor underactivity among a cohort of 2092 women, concerning the three urodynamic definitions, was 33.7%, 37.0% and 4.1%, respectively. Age, menopausal status, voiding/bulging symptoms, anterior and central prolapse, first desire to void and positive postvoid residual were directly related to detrusor underactivity. Conversely, stress urinary incontinence, detrusor pressures during voiding and maximum flow were inversely associated. Final models for detrusor underactivity resulted in poor accuracy for all considered definitions. Conclusions The prevalence of detrusor underactivity varies depending on the definition considered. Although several clinical variables resulted as independent predictors of detrusor underactivity, instrumental evaluation still plays a key role in the diagnosis.

show abstract

Detrusor underactivity in pelvic organ prolapse

Cited by 42 publications

References 33 publications

Systematic review of lower urinary tract symptoms occurring with pelvic organ prolapse

Systematic review of lower urinary tract symptoms occurring with pelvic organ prolapse

Clinical Guidelines for Female Lower Urinary Tract Symptoms (second edition)

Detrusor underactivity prevalence and risk factors according to different definitions in women attending urogynecology clinic

Contact Info

Product

Resources

About