Predictors for detrusor overactivity following extensive vaginal pelvic reconstructive surgery

Lo, Tsia‐Shu; Shailaja, Nagashu; Hsieh, Wu‐Chiao; Uy-Patrimonio, Ma. Clarissa; Lin, Yi‐Sheng

doi:10.1002/nau.23273

Cited by 22 publications

(15 citation statements)

References 27 publications

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“…One might be reluctant to perform prophylactic incontinence surgery in women with detrusor underactivity or voiding dysfunction. Lo et al found in a considerable number of women with advanced prolapse a sign of bladder outlet obstruction. However, the overall incidence of postoperative voiding dysfunction was only 3.5% and 1% developed de novo voiding dysfunction .…”

Section: Discussionmentioning

confidence: 99%

The predictive value of demonstrable stress incontinence during basic office evaluation and urodynamics in women without symptomatic urinary incontinence undergoing vaginal prolapse surgery

Ploeg

Zwolsman

Posthuma

et al. 2017

Neurourology and Urodynamics

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Section: Discussionmentioning

confidence: 99%

The predictive value of demonstrable stress incontinence during basic office evaluation and urodynamics in women without symptomatic urinary incontinence undergoing vaginal prolapse surgery

Ploeg

Zwolsman

Posthuma

et al. 2017

Neurourology and Urodynamics

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“…Long et al demonstrated that age (<60 years) was one of the significant predictors of postoperative OAB improvement . Also, Lo et al demonstrated that age (≥66 years) was the independent risk factor for persistence of postoperative detrusor overactivity (DO) . A possible explanation would be that older women have more severe damage to nerves and detrusor muscles in the bladder than younger women.…”

Section: Discussionmentioning

confidence: 99%

“…Liang et al demonstrated that a preoperative maximal cystometric capacity <300 mL was associated with persistent UUI after prolapse repair . Further, Lo et al identified predictors for DO in women who received extensive vaginal pelvic reconstructive surgery for advanced POP . They concluded that preoperative maximum urethral closure pressure ≥60 cmH 2 O, maximum flow rate < 15 mL, and Pdet@Q max ≥20 cmH 2 O were independent risk factors for developing postoperative DO following vaginal pelvic reconstructive surgery …”

Section: Discussionmentioning

confidence: 99%

Predictive factors for persistence of preoperative overactive bladder symptoms after transvaginal mesh surgery in women with pelvic organ prolapse

Otsuka

Watanabe

Matsushita

et al. 2019

LUTS

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Background: We aimed to evaluate the effect of transvaginal mesh surgery on overactive bladder symptoms in women with pelvic organ prolapse and to identify predictive factors for persistence of a preoperative overactive bladder after surgery. Materials and Methods:We retrospectively evaluated 102 patients who underwent transvaginal mesh surgery. All patients had stage 2 or greater pelvic organ prolapse accompanied by cystocele. The Overactive Bladder Symptom Score, International Prostate Symptom Score, uroflowmetry, and postvoid residual urine volume were evaluated preoperatively and 6 months postoperatively. To identify predictive factors for the persistence of a preoperative overactive bladder after surgery, preoperative parameters were statistically compared between patients with and without the persistence of preoperative overactive bladder symptoms. Receiver operator characteristic curves were generated, and the area under the curve was calculated.Results: Preoperatively, 54 women (53%) had an overactive bladder. After surgery, the symptoms disappeared in 34 (63%) and persisted in 20 (37%) women. There were no significant differences in preoperative parameters including age, body mass index, parity, or severity of pelvic organ prolapse between patients with and without persistent preoperative overactive bladder. Preoperative Overactive Bladder Symptom Score and International Prostate Symptom Score were significantly higher in patients with persistent preoperative overactive bladder symptoms. The International Prostate Symptom Score storage subscore had the highest area under the curve, with a cutoff value of 9.5. Conclusion: Transvaginal mesh surgery eliminates overactive bladder symptoms inabout two-thirds of pelvic organ prolapse patients. The preoperative International Prostate Symptom Score storage subscore was the most useful predictive factor for the persistence of preoperative overactive bladder symptoms after surgery. K E Y W O R D S female, International Prostate Symptom Score, overactive bladder, pelvic organ prolapse, transvaginal mesh surgery

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“…Of the 1202 women without preoperative DO, 3.5% developed de novo DO. Preoperative independent predictors of persistent or de novo DO included: age >65 years, neurological disease such as Parkinson's, BOO or elevated PVR >200 mL [32].…”

Section: Risk Factors For Persistence Of Oab After Surgical Repairmentioning

confidence: 99%

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

Cameron

2019

Arab Journal of Urology

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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.

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Predictors for detrusor overactivity following extensive vaginal pelvic reconstructive surgery

Abstract: Age ≥66 year, neurological factors like CVA and Parkinsonian disease, pre-operative MUCP ≥60 cmH O, MFR < 15 mL, Dmax ≥ 20 cmH O, and PVR ≥ 200 mL are independent risk factors for developing post-operative DO following vaginal PRS for advanced POP.

Cited by 22 publications

References 27 publications

The predictive value of demonstrable stress incontinence during basic office evaluation and urodynamics in women without symptomatic urinary incontinence undergoing vaginal prolapse surgery

The predictive value of demonstrable stress incontinence during basic office evaluation and urodynamics in women without symptomatic urinary incontinence undergoing vaginal prolapse surgery

Predictive factors for persistence of preoperative overactive bladder symptoms after transvaginal mesh surgery in women with pelvic organ prolapse

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

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