To investigate the association between urodynamic findings and lower urinary tract symptoms (LUTS) before and after surgical treatment of POP.
Seventy-four patients with stage II or more anterior POP associated with LUTS and eligible for surgical repair of POP were included in this prospective study. All cases had clinical evaluation and urodynamic testing (UDS) before and 6 months after surgical repair of POP.
Mean age was 45±9 years. Mean BMI was 28±6 kg/m2. Most cases were multiparous, had stage III cystocele (50/74, 68%), and an associating apical prolapse (37/74, 50%). Native tissue repair was done in 53/74 (72%) cases with a concomitant anti-incontinence procedure (AIP) in 41/74 (55%) for overt (26/74, 35%) or occult (15/74, 20%) stress urinary incontinence (SUI). Preoperative UDS revealed detrusor overactivity (DO) in 19/56 (34%) patients of those presenting with storage LUTS and an obstructed PdetQmax in 20/26 (77%) patients presenting with voiding LUTS. At the 6-month postoperative follow-up, 61/74 (82%) patients had marked improvement of their LUTS, SUI resolved in 39/41 (95%) patients and 1/33 (3%) patient developed de novo SUI. Preoperative DO and post-void residual urine volume (PVR) were not related to the postoperative improvement, or persistence of LUTS. Meanwhile, detrusor underactivity (DU) was detected both on preoperative and postoperative UDS of 4 patients with persistent voiding LUTS.
Patients had significant improvement in LUTS after POP surgery with or without an AIP. DU was associated with persistence of voiding LUTS. Meanwhile, preoperative DO and PVR were of limited prognostic value.
Urology. 2022 Jun 14 [Epub ahead of print]
A M Tawfeek, Tarek Osman, Hany Hamed Gad, Mohamed Elmoazen, Dana Osman, Ahmed Emam
Department of Urology, Ain Shams University, Cairo, Egypt. Electronic address: ., Department of Urology, Ain Shams University, Cairo, Egypt. Electronic address: ., Department of Urology, Ain Shams University, Cairo, Egypt. Electronic address: ., Department of Urology, Ain Shams University, Cairo, Egypt. Electronic address: ., Department of Urology, Ain Shams University, Cairo, Egypt. Electronic address: ., Department of Urology, Ain Shams University, Cairo, Egypt. Electronic address: .