Urodynamic findings in women with pelvic organ prolapse and obstructive voiding symptoms

Dain, Lena; Auslander, Ron; Rosen, Talma; Segev, Yakir; Goldschmidt, Eyal; Abramov, Yoram

doi:10.1016/j.ijgo.2010.06.007

Cited by 17 publications

(10 citation statements)

References 16 publications

(16 reference statements)

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“…Some studies have demonstrated that half of all women with POP have a feeling of incomplete bladder emptying, but only 30% of the patients with advanced POP have urodynamic evidence of BOO [9,10]. Some studies tried to suggest an association between BOO and bladder trabeculation in stress urinary incontinence (SUI) patients, but there are no objective evidences of such.…”

Section: Introductionmentioning

confidence: 99%

The significance and factors related to bladder outlet obstruction in pelvic floor dysfunction in preoperative urodynamic studies: A retrospective cohort study

Lee

Kim

et al. 2014

Obstet Gynecol Sci

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ObjectiveTo demonstrate the significance of bladder outlet obstruction (BOO) in preoperative urodynamic studies (UDS) in women who have been diagnosed with pelvic floor dysfunction including pelvic organ prolapsed (POP) and stress urinary incontinence (SUI).MethodsThe medical records of 150 patients with pelvic floor dysfunction who underwent preoperative UDS at Yonsei University Health System from 2006 to 2012 were reviewed. Under the criteria of BOO, as a maximal flow rate in free-flow study (Qmax) less than 12 mL/sec and a detrusor pressure at Qmax in pressure-flow study (PdetQmax) higher than 20 cmH2O in UDS, they were divided into two groups: a group of 50 patients with BOO and a group of 100 patients without BOO. Comparisons were made between the patients with and without BOO in preoperative UDS.ResultsIn the POP-with-SUI group, 25 patients with BOO had lower mean Qmax (10.0 vs. 25.4 mL/sec, P < 0.001), higher PdetQmax (49.6 vs. 21.5 cmH2O, P < 0.001), lower maximum cystometric capacity (422.7 vs. 454.0 mL, P = 0.007), and higher postvoidal residual volume (44.3 vs. 21.1 mL, P = 0.021) than the patients without BOO. In the SUI-only group, the mean Qmax was significantly lower in the 25 patients with BOO (9.4 vs. 25.4 mL/sec, P < 0.001). The mean PdetQmax was significantly higher with BOO (39.6 vs. 25.4 cmH2O, P = 0.004). In the univariate analyses, menopause, maximum cystometric capacity, and cystoscopic bladder trabeculation were associated with BOO.ConclusionIn the univariate analysis, menopause, MCC and cystoscopic bladder trabeculation were associated with BOO. In the multivariate model, however, no significant association with BOO was found.

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Section: Introductionmentioning

confidence: 99%

The significance and factors related to bladder outlet obstruction in pelvic floor dysfunction in preoperative urodynamic studies: A retrospective cohort study

Lee

Kim

et al. 2014

Obstet Gynecol Sci

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“…For the diagnosis of voiding dysfunction, some studies use only the criterion of decreased urinary flow rate (5) or just the increase in PVR criterion (6-8). Other studies use both criteria but independently of one another (11, 19), and this modifies all the results obtained. Additionally, there is another group of studies that only considers the bladder outlet obstruction diagnosis, without assessing those patients with a reduced detrusor contractility, thus having an impact on conclusions (10, 12, 20).…”

Section: Discussionmentioning

confidence: 99%

Voiding symptoms obtained by open versus directed anamnesis as predictors of voiding dysfunction in women

et al. 2019

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Objectives To determine the differences between voiding symptoms obtained by open anamnesis (VS-Open) versus voiding symptoms obtained by directed anamnesis (VS-Directed) to predict voiding dysfunction in women.Materials and Methods Retrospective study of women with prior anti-incontinence surgery evaluated during 5 years. In a standardized clinical history taking, each patient was asked to answer question number five of the UDI-6 questionnaire (“Do you experience any difficulty emptying your bladder?”). If the answer was positive, the following voiding symptoms spontaneously described by the patient were documented: slow urine stream, straining to void, intermittent stream and feeling of incomplete bladder emptying, which were considered VS-Open. If the answer to this question was negative or if the patient had not reported the four voiding symptoms, she was asked in a directed manner about the presence of each o Ninety-one women are analyzed. Eighteen patients presented voiding dysfunction (19.8%), There was a statistical association between voiding dysfunction and the presence of any VS-Open (p = 0.037) and straining to void obtained by open anamnesis (p = 0.013). Sensitivity, specificity, PPV, NPV, positive likelihood ratio and negative likelihood ratio, respectively, were 44.4% and 27.8%, 80.8% and 94.5%, 36.3% and 55.6%, 85.5% and 84.1%, 2.324 and 5.129, and 0.686 and 0.764. There was no statistical association between voiding dysfunction and VS-Directed.ConclusionsVS-Open may predict better voiding dysfunction than VS-Directed in women.

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“…Anterior compartment problem of cystocele can be investigated using patient history, physical examination, transperineal US, or MRI [1]. One main shortfall of 3D EVUS for assessing stress urinary incontinence (SUI) is that meaningful dynamic imaging cannot be performed by this method due to the presence of the transducer in the vaginal canal.…”

Section: Discussionmentioning

confidence: 99%

“…Pelvic organ prolapse (POP) and pelvic floor disorders (PFD), such as voiding and defecatory dysfunction, are complex problems with varied and hotly debated empirical solutions, including traditional repairs, mesh placement, or physical therapy [1]. The lifetime risk of prolapse or urinary incontinence (UI) operation in the United States is 11-19% [2,3].…”

Section: Introductionmentioning

confidence: 99%

Anterior and posterior compartment 3D endovaginal ultrasound anatomy based on direct histologic comparison

et al. 2012

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Urodynamic findings in women with pelvic organ prolapse and obstructive voiding symptoms

Abstract: Almost half of all women with advanced POP experienced incomplete bladder emptying; however, this symptom did not correlate with objective urodynamic bladder outflow tract obstruction.

Cited by 17 publications

References 16 publications

The significance and factors related to bladder outlet obstruction in pelvic floor dysfunction in preoperative urodynamic studies: A retrospective cohort study

The significance and factors related to bladder outlet obstruction in pelvic floor dysfunction in preoperative urodynamic studies: A retrospective cohort study

Voiding symptoms obtained by open versus directed anamnesis as predictors of voiding dysfunction in women

Anterior and posterior compartment 3D endovaginal ultrasound anatomy based on direct histologic comparison

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