Resolution of Motor Urge Incontinence After Surgical Repair of Pelvic Organ Prolapse

Nguyen, John N.; Bhatia, Narender N.

doi:10.1016/s0022-5347(05)65547-4

Cited by 79 publications

(36 citation statements)

References 6 publications

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“…Digesu et al [17] showed a significant improvement in overactive bladder symptoms after surgical repair of symptomatic anterior vaginal wall prolapse (stage ≥2) and a resolution of urge UI in 45% while Nguyen and Bhatia [18] reported a cure rate of 63% after surgical repair of uterine and/or vaginal vault prolapse compared to our cure rate of 33%. Milani et al on the other hand showed, in a study of vaginal repair with Prolene mesh, a high anatomical success rate of 93% with no change in urge or stress UI preoperatively and postoperatively [19] Although the relationship between stage of prolapse and bowel symptoms has been found to be weak [20,21], women with prolapse have been shown in a recent study to be more likely to suffer from difficult defaecation and faecal incontinence compared to matched controls [22].We found an improvement of difficulty in emptying bowels after traditional posterior colporrhaphy.…”

Section: Discussioncontrasting

confidence: 47%

A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse

et al. 2008

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The objective of this study was to evaluate anatomic, functional, short- and long-term outcome of vaginal surgery for pelvic organ prolapse. This was a prospective observational study of 185 consecutive women planned for vaginal prolapse reconstructive surgery. Stage of prolapse, urinary incontinence (UI), bowel and mechanical symptoms were assessed preoperatively and at 1, 3 and 5 years postoperatively. The mean follow-up time was 53 months. The anatomic recurrence rate was 41.1% but less than half of them were symptomatic. Anterior compartment was most prone for recurrence and the majority of the recurrences took place within the first year. UI remained at the same level at 1-year follow-up. De novo urge occurred in 22.6% and de novo stress incontinence in 6.0%. An improvement was seen in difficulty in emptying bowel 1 year after surgery (54%). Patients were primarily cured from mechanical symptoms. Re-operation rate was 9.7%; if additional operation for incontinence was included, it was13.5%.

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Section: Discussioncontrasting

confidence: 47%

A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse

et al. 2008

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“…In this study, we have shown significant improvement in these symptoms after anterior repair. Our findings extend and support previous studies [22,23] of the effect of surgical repair of grade 2 or more prolapse on symptoms of urge incontinence. The relationship between the severity of anterior wall prolapse and urinary symptoms is, however, far from clear.…”

Section: Discussionsupporting

confidence: 91%

“…Median parity was 2.5 (range 0-4) and body mass index 23 (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32). Eleven women were premenopausal, 32 were on treatment with hormone replacement therapy preoperatively, and 114 (59%) were sexually active.…”

Section: Resultsmentioning

confidence: 99%

Symptomatic and quality of life outcomes after site-specific fascial reattachment for pelvic organ prolapse repair

et al. 2007

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The aim of this study was to assess symptomatic and quality of life outcome scores following site specific fascial reattachment surgery for pelvic organ prolapse using the validated Prolapse Quality of Life (P-QOL) questionnaires. One hundred and ninety two women underwent surgery for pelvic organ prolapse; ninety four underwent anterior repair (thirty four of them had vaginal hysterectomy), and ninety eight had posterior repair. Patients filled P-QOL questionnaires 24 hours prior to surgery and a postal P-QOL questionnaire six months post operatively. Pre and post operative questionnaires were paired. Quality of life and symptoms scores were calculated using Wilcoxon signed rank test. One hundred and one women returned their questionnaires and were suitable to include in the study. Forty nine underwent anterior repair (fifteen had vaginal hysterectomy) and 52 underwent posterior repair. Quality of life scores showed significant improvement in the anterior and posterior repair groups with the exception of general health in the anterior repair group and general health and prolapse impact in the posterior repair group. Anterior repair significantly improved urinary voiding and storage symptoms. Posterior repair group showed significant improvement in defecatory symptoms. Both groups showed improvement in sexual function and general prolapse symptoms. Prolapse repair with site specific fascial reattachment results in significant improvement in quality of life scores six months after surgery. Anterior repair improves urinary voiding and storage symptoms and posterior repair improves defecatory dysfunction and urinary voiding. Sexual function improves following prolapse repair with site specific fascial reattachment.

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“…Quality-of-life measures also showed statistically significantly improvement at 12-month follow-up [30]. Nguyen and Bhatia [31] analyzed 38 women with grade 2 or greater POP (Baden-Walker system), all with DO on UDS along with symptomatic urgency incontinence, and reported a 63% resolution of urgency incontinence after POP repair, including both abdominal and vaginal reconstruction. Again, patients undergoing antiincontinence procedures were excluded.…”

Section: Surgical Repair Of Pelvic Organ Prolapsementioning

confidence: 99%

“…Lower amplitude of uninhibited detrusor contraction on UDS preoperatively and presence of bladder trabeculation on cystoscopy were correlated with resolution of urge incontinence. Four patients who were subjectively "improved" but did not report symptoms as "resolved" were grouped with persistent urge incontinence, possibly diluting the positive impact of repair [31]. Crafoord et al [32] surveyed 188 patients for pelvic floor dysfunction who had undergone POP repair a mean 5.9 years prior to the questionnaire.…”

Section: Surgical Repair Of Pelvic Organ Prolapsementioning

confidence: 99%

Overactive Bladder Prevalence after Surgery for Pelvic Organ Prolapse

Menchen

Smith

2011

Curr Bladder Dysfunct Rep

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In this review, we set out to address the clinically complex question of how patients with overactive bladder (OAB) syndrome and pelvic organ prolapse (POP) fare with respect to symptomatic improvement after surgical treatment of POP. Our objectives are to use the current literature to define appropriate patient expectations for improvement and cure and to look for factors predicting divergent outcomes, with the goal of offering realistic preoperative patient counseling. Secondary aims include highlighting areas of needed research, defining outcome measures, and examining theories regarding the relationship between OAB and POP. Relevant original papers and review articles were identified by conducting a literature search using PubMed and Medline. The cause of OAB symptoms and the relationship between vaginal wall prolapse and OAB remain unclear. However, POP repair seems to improve the symptoms of OAB syndrome in 30% to 80% of patients, with a small but significant percentage of patients (≤20%) developing de novo symptoms of OAB.

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Resolution of Motor Urge Incontinence After Surgical Repair of Pelvic Organ Prolapse

Abstract: In most women with grade 2 or greater uterovaginal and coexistent motor urge incontinence urge incontinence resolved after the surgical repair of prolapse.

Cited by 79 publications

References 6 publications

A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse

A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse

Symptomatic and quality of life outcomes after site-specific fascial reattachment for pelvic organ prolapse repair

Overactive Bladder Prevalence after Surgery for Pelvic Organ Prolapse

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