Is Urodynamic Study an Essential Step in Preoperative Evaluation of Women with Pelvic Organ Prolapse with Urinary Tract Dysfunction: Prospective Comparative Study

Abstract

Aim: Pelvic organ prolapse (POP) is commonly associated with lower urinary tract dysfunction The preoperative urodynamics as a standard investigation for urinary incontinence (UI) has been a subject of debate.We aimed to compare the clinical impact of urodynamics versus office clinical evaluation only before surgical management of POP. Study Design: prospective comparative study. Patients and Methods: 60 women in Shatby Maternity hospital with (POP) and lower urinary tract dysfunction have been thoroughly evaluated by history, examination and standardized questionnaire. 30 of them group (1) were subjected to pre-operative urodynamic studies. Post-operative urological dysfunction were compared and analyzed. Results: Urodynamic study identified urinary dysfunction in 80% of women in group 1. However in group (2), 6 patients out of 16 (37.5%) had stress urinary incontinence post-surgery that was not diagnosed preoperatively. These patients were POP stage 3. In group (1); no occult stress incontinence was observed in any of the patients of this group postoperatively. Conclusions: Urological profile of patients whose surgical management of pelvic organ prolapse was planned according to urodynamics finding had been improved. So we recommend urodynamics to be an integral part of diagnostic work up of pelvic organ prolapse patients.