Hydronephrosis Associated With Pelvic Organ Prolapse: A Systematic Review

Abstract

Objectives The aim of this study was to report the prevalence of hydronephrosis associated with pelvic organ prolapse (POP). Methods We conducted a MEDLINE and PubMed search from 1996 to October 2016 using PRISMA guidelines. Eight studies met criteria for inclusion, including 3 prospective and 5 retrospective studies. Results The prevalence of hydronephrosis ranged from 3.5% to 30.6% in studies that included multiple stages of prolapse. Hydronephrosis correlated with prolapse severity in multiple studies, but serum creatinine did not consistently predict hydronephrosis. Two studies reported a significantly higher prevalence of hydronephrosis in patients with uterovaginal prolapse compared with vaginal vault prolapse. Complete resolution of hydronephrosis was described in 56% to 83% of patients after undergoing surgical treatment for advanced prolapse. Conclusions Hydronephrosis among patients with POP is not rare, and we suggest consideration of upper tract evaluation in patients presenting with POP, particularly in those with advanced uterovaginal prolapse electing to proceed with expectant or conservative management.

Acute Obstructive Pyelonephritis Due to Pelvic Organ Prolapse: a case-based Review of the Literature

“…Hydronephrosis in POP is not a rare condition and must be screened for, in the context of a patient presenting with POP: in fact, a systematic review carried out by Siddique et al reported that the prevalence of hydronephrosis in POP ranges from 3.6 to 30.6% depending on the studies and showed that uterovaginal prolapse was more accountable for hydronephrosis and especially severe hydronephrosis than vaginal vault prolapse [ 6 ]. No study demonstrated a statistically significant association between severity or duration of the prolapse and stage of the hydronephrosis, but a more severe prolapse was associated with a higher prevalence of hydronephrosis.…”

“…No study demonstrated a statistically significant association between severity or duration of the prolapse and stage of the hydronephrosis, but a more severe prolapse was associated with a higher prevalence of hydronephrosis. Nonetheless, POP severity was not found to cause higher serum creatinine levels [ 6 ]. Consequently, creatinine levels were within normal values and remained as such regardless of the chronicity and severity of POP.…”

Hydronephrosis associated with pelvic organ prolapse: a review study

“…Pelvic organ prolapse (POP) is a common condition affecting more than 3 million women worldwide 1 . It may lead to bothersome pelvic pressure, bulge symptoms, and voiding dysfunction from bladder outlet obstruction, which may manifest as reduced flow rates and elevated postvoid residual volumes.…”

“…It may lead to bothersome pelvic pressure, bulge symptoms, and voiding dysfunction from bladder outlet obstruction, which may manifest as reduced flow rates and elevated postvoid residual volumes. Therefore, POP can also be associated with recurrent urinary tract infections, ureteral obstruction, and hydronephrosis (HD) 1,2 .…”

“…This condition is concerning because it can be completely asymptomatic. In addition, HD can result in silent kidney damage, which may lead to chronic or even end-stage renal failure 1,2 .…”