Does urethral competence affect urodynamic voiding parameters in women with prolapse?

Published

Journal Article

AIMS: To (1) compare voiding parameters and (2) correlate symptoms and urodynamic findings in women with pelvic organ prolapse (POP) and varying degrees of urethral competence. METHODS: We compared three groups of women with stages II-IV POP. Groups 1 and 2 were symptomatically stress continent women participating in the Colpopexy and Urinary Reduction Efforts (CARE) trial; during prolapse reduction before sacrocolpopexy, Group 1 (n = 67) did not have and Group 2 (n = 84) had urodynamic stress incontinence (USI) during prolapse reduction. Group 3 participants (n = 74), recruited specifically for this study, had stress urinary incontinence (SUI) symptoms and planned sacrocolpopexy. Participants completed standardized uroflowmetry, pressure voiding studies, and validated symptom questionnaires. RESULTS: Subjects' median age was 61 years, median parity 3 and 87% had stage III or IV POP. Fourteen percent of women in Group 3 demonstrated USI without, and 70% with, prolapse reduction. Women in Groups 2 and 3 had more detrusor overactivity (DO) than Group 1 (17 and 24% vs. 6%, P = 0.02) and detrusor overactivity incontinence (DOI) (15 and 8% vs. 0%, P = 0.004). Based on the Blaivis-Groutz nomogram, 60% of all women were obstructed. Post-void residual volume (PVR), peak flow rate, detrusor pressure at peak flow, voiding mechanisms, voiding patterns, obstruction and urinary retention did not differ among groups. Women in Group 3 had higher irritative and obstructive symptom scores than Group 1 or 2; neither score differed by presence of DO nor obstruction, respectively. CONCLUSION: Women with POP have significant rates of urodynamic obstruction and retention, independent of their continence status. Symptoms of obstruction and retention correlate poorly with urodynamic findings.

Full Text

Duke Authors

Cited Authors

  • Nygaard, I; Kreder, K; Mueller, E; Brubaker, L; Goode, P; Visco, A; Weber, AM; Cundiff, G; Wei, J; Pelvic Floor Disorders Network,

Published Date

  • 2007

Published In

Volume / Issue

  • 26 / 7

Start / End Page

  • 1030 - 1035

PubMed ID

  • 17638306

Pubmed Central ID

  • 17638306

International Standard Serial Number (ISSN)

  • 0733-2467

Digital Object Identifier (DOI)

  • 10.1002/nau.20436

Language

  • eng

Conference Location

  • United States