The effect of uterovaginal prolapse on urethrovesical pressure dynamics

Richardson, Diane; Bent, Alfred E.; Ostergard, Donald R.

doi:10.1016/0002-9378(83)90961-4

Cited by 194 publications

(120 citation statements)

References 6 publications

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“…Asymptomatic women with severe pelvic organ prolapse maybe at increased risk of manifesting stress urinary incontinence after the prolapse has been reduced. 6,7,12 Women with prolapse maintain continence despite poor urethral sphincteric function due to either urethral kinking or increased urethral resistance. 13 Many studies have shown that patient symptomatology is unreliable for a proper diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…13 According to literature, 36% to 80% of women with advanced prolapse are at risk for SUI after corrective surgery. 6,11,12,15,16 In a study by Chaikin et al, when urodynamic studies were used following reduction of prolapse with a pessary 14 out of 24 (58%) women demonstrated sphincteric incontinence. 11 In a study by Blaivas et al, the incidence of stress incontinence after prolapse reduction with pessary was 32%.…”

Section: Discussionmentioning

confidence: 99%

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Study of occult stress urinary incontinence in pelvic organ prolapse

Reddy

Ghose

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONPelvic organ prolapse (POP) and stress urinary incontinence (SUI) are two common health-related conditions. They affect up to 50% women worldwide individually.1 Stress urinary incontinence is a condition of involuntary loss of urine on effort, physical exertion, sneezing, or coughing that is often bothersome to the patient and frequently affects the quality of life. It is estimated to affect 15.7% of adult women.2 Many times this urinary incontinence is detected following corrective prolapse surgery. If a woman with pelvic organ prolapse leaks only when the prolapse is reduced, it is called occult stress urinary incontinence (OSUI). 3The prevalence of OSUI in women with severe genitourinary prolapse varies from 27-68% in literature. 4,5 If any previously continent woman develops urinary incontinence after vaginal hysterectomy and pelvic floor repair, it is a frustrating condition for both the patient and the physician.So it is important to counsel symptomatically continent women with POP for developing post-operative SUI (POSUI). Bump RC et al and Fianu et al have showed that POP, may mask SUI. 6,7 The colpopexy and urinary reduction efforts(CARE) study, the largest randomized trial, showed that 45% of women with POP developed POSUI subjectively and objectively as well. [8][9][10] In a study ABSTRACT Background: Pelvic organ prolapse and stress urinary incontinence are two common health-related conditions. If a woman with pelvic organ prolapse leaks only when the prolapse is reduced, it is called occult stress urinary incontinence (OSUI). The prevalence of OSUI in women with severe genitourinary prolapse varies from 27-68% in literature. In this study we want to find out the relationship between OSUI and stress urinary incontinence (SUI) following corrective surgery.The objectives of the study are to determine the number of women with urinary leak following reduction of prolapse before surgery; to determine the number women with occult stress urinary incontinence developing stress urinary incontinence following surgery and to determine the risk of developing stress urinary incontinence after vaginal hysterectomy and pelvic floor repair in these women. Methods: This is a longitudinal observational study. All women with pelvic organ prolapse (POP) of grade II or higher requiring corrective surgery were initially evaluated for OSUI using vaginal pack and followed up post operatively at 6 weeks and 12 weeks using QUID to look for post-operative stress urinary incontinence (POSUI). Results:The overall incidence of OSUI in our study was 7.5%. OSUI was significantly associated with factors like older age, higher BMI, high parity, short inter pregnancy interval and higher grade of prolapse and not significantly associated with factors like place of delivery, delivery events and mode of delivery. Conclusions:It is important to test all women with POP for OSUI and patients with OSUI need long term follow up to detect POSUI

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Study of occult stress urinary incontinence in pelvic organ prolapse

Reddy

Ghose

2017

Int J Reprod Contracept Obstet Gynecol

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“…Also 64.2% of the women with a positive result to the preoperative Pyridium pad test after pessary insertion were found to have urinary incontinence postoperatively. Therefore preoperative testing is useful to identify women with genitourinary prolapse who have occult SUI and women with a positive result may need a systematic clinical evaluation and urodynamic studies to characterize the incontinence [6]. Indeed, whether urodynamic evaluation has an impact on the choice of, or outcome of surgery still remains controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore numerous studies have been done on the effectiveness of concomitant prophylactic anti-incontinence surgery at the time of POP surgery and whether preoperative UDS can predict SUI following POP surgery. According to the literature, 36% to 80% of women with advanced vaginal prolapse are at risk of SUI after vaginal reconstructive surgery and they required a concurrent surgery for POP and incontinence repair [6][7][8][9][10]. Many studies reported that prophylactic anti-incontinence surgery led to better surgical outcomes.…”

mentioning

confidence: 99%

Effective parameters of urodynamic study before pelvic organ prolapse surgery and validation of concomitant surgery on urinary outcomes: Retrospective cohort study

Cho

Kim

Moon

et al. 2012

Korean J Obstet Gynecol

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“…Diferentes estudios han demostrado la presencia de incontinencia de esfuerzo oculta en mujeres con cistocele severo, en cifras que van desde el 30 al 80% 7,14,15,20,21 . Nuestra serie la presentó en el 63,2%.…”

Section: Discussionunclassified

Incontinencia urinaria oculta evidenciada por estudio urodinámico preoperatorio en pacientes con prolapso genital severo

Arriola

Dalenz

Schanz

2008

Actas Urológicas Españolas

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RESUMENINCONTINENCIA URINARIA OCULTA EVIDENCIADA POR ESTUDIO URODINÁMICO PREOPERATORIO EN PACIENTES CON PROLAPSO GENITAL SEVERO Objetivos: Revisar la eficacia de la urodinamia monocanal realizada con corrección del prolapso genital severo, mediante valva de Bresky, en la pesquisa de incontinencia de orina oculta, como prueba prequirúrgica, para planificar una corrección mediante cinta submedio uretral concomitantemente con la cirugía de prolapso.Paciente y Método: Pacientes ingresadas a la Unidad de Uroginecología de Clínica Las Condes, entre enero del 2006 y diciembre del 2007, debido a cistocele grado III o IV. Pacientes sin antecedentes de cirugía de prolapso o incontinencia de orina. Se realiza una urodinamia monocanal con corrección del prolapso mediante una valva de Bresky. Se realiza medición de presión de retro-resistencia uretral y cistometría. En aquellas mujeres en que se descarta la presencia de incontinencia oculta, se realiza corrección del prolapso mediante malla Prolift. En aquellas en que se encuentra incontinencia oculta, se coloca concomitantemente, una cinta sub-medio uretral profilác-tica, para evitar la aparición de incontinencia de orina en el postoperatorio.Resultados: De las treinta y ocho mujeres que cumplieron el criterio de ingreso a este estudio, 14 (36,8%) no registraron presencia de incontinencia de esfuerzo oculta durante la urodinamia. En las 24 (63,2%) restantes se evidenció incontinencia de orina de esfuerzo. Tipo I, en 1; tipo II en 12; tipo III en 1; tipo II+III en 10. Durante la cistometría 3 de ellas registraron un detrusor hiperactivo asintomático. En 1 (4,2%) de las 24 pacientes sometidas a cirugía profiláctica de incontinencia, se registró falla, con escapes de orina durante el postoperatorio inmediato. El resto (23) no presentó incontinencia durante el postoperatorio inmediato, temprano, ni tardío, completando un período de observación entre 4 y 24 meses. En las 14 mujeres con cirugía sólo para el prolapso, tampoco se registró aparición de incontinencia.Conclusiones: La urodinamia con corrección del prolapso genital severo, mediante valva de Bresky, es un método eficiente en la detección de incontinencia de orina oculta. Lo que nos permite planificar una posible cirugía anti-incontinencia profiláctica. Que según nuestra experiencia, es un método seguro y eficaz. De esta forma, se entrega una solución integral, a un problema del suelo pelviano que frecuentemente se asocia, por compartir los mismos factores de riesgo y que significa un alto grado de deterioro de la calidad de vida.Palabras clave: Prolapso genital. Incontinencia urinaria. Incontinencia oculta. Urodinamia. ABSTRACT OCCULT STRESS INCONTINENCE IDENTIFY BY PREOPERATIVE URODYNAMIC STUDY IN WOMEN WITH SEVERE PELVIC ORGANPROLAPSE Objective: To review the effectiveness of preoperative urodynamic study made with correction of the severe genital prolapse by Bresky valve in the diagnosis of urinary occult incontinence, in order to plan a correction with a prophylactic sub-mid urethral mesh in the prolapse surgery.Pat...

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The effect of uterovaginal prolapse on urethrovesical pressure dynamics

Cited by 194 publications

References 6 publications

Study of occult stress urinary incontinence in pelvic organ prolapse

Study of occult stress urinary incontinence in pelvic organ prolapse

Effective parameters of urodynamic study before pelvic organ prolapse surgery and validation of concomitant surgery on urinary outcomes: Retrospective cohort study

Incontinencia urinaria oculta evidenciada por estudio urodinámico preoperatorio en pacientes con prolapso genital severo

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