Description and Classification of Lower Urinary Tract Dysfunction and Pelvic Organ Prolapse

Author(s):  
Mark D. Walters
Author(s):  
Neha Khatik ◽  
Ratna Biswas

Background: Utero-vaginal prolapse is a common gynecological disorder, result from weakness of musculoskeletal structure that support the pelvic organ. Although it is not an emergency situation but severely affect the quality of life. Women with utero-vaginal prolapse may present with lower urinary tract dysfunction but association of urological changes with UV prolapse and beneficial effect of surgery on these changes is still debatable. Urodynamic study such as cystometry and uroflowmetry help in better understanding of lower urinary tract dysfunction and assist to plan appropriate surgical management thereby reduce chances of postoperative voiding dysfunction.Methods: A total of 30 women of pelvic organ prolapse with lower urinary tract dysfunction, over a period of one year, were subjected to urodynamic studies after thorough evaluation by history, examination and standardized questionnaire both pre and post operatively and data analysed.Results: In present study, urodynamic study identified urinary dysfunction in 93.34% of women recruited in study. Obstruction was present in 36.67% of women. Detrusor overactivity along with obstruction was seen in 20.00% of women. Urodynamic stress incontinence and urodynamic stress incontinence along with obstruction was identified in 13.33% of women each and detrusor overactivity was observed in 10.00% of women.Conclusions: In present study it was found that, if surgical management of pelvic organ prolapse is planned according to urodynamic study, it will improve urologic profile of patients. To conclude that urodynamic study should be an integral part of diagnostic work up of uterovaginal prolapse patients require larger sample size and at least 6 months follow-up duration after surgery.


2011 ◽  
Vol 30 (5) ◽  
pp. 775-782 ◽  
Author(s):  
Tamer Aboushwareb ◽  
Patrick Mckenzie ◽  
Felix Wezel ◽  
Jennifer Southgate ◽  
Gopal Badlani

2018 ◽  
Vol 67 (4) ◽  
pp. 4-12
Author(s):  
Elena I Rusina

Lower urinary tract dysfunction (LUTD) is often the main reason for patients with pelvic organ prolapse (POP) to see a doctor. LUTD can be caused by a variety of pathophysiological reasons that are underestimated in preoperative examination and are not taken into account when planning treatment. Application of examination algorithms using modern urodynamic methods in patients with LUTD and POP can lead to an improvement in the functional results of treatment. (For citation: Rusina EI. Lower urinary tract dysfunction in women with pelvic organ prolapse: Diagnostic problems. Journal of Obstetrics and Women’s Diseases. 2018;67(4):4-12. doi: 10.17816/JOWD6744-12).


Author(s):  
Nanthini Saravanan ◽  
Aruna N. Kekre ◽  
Mahasampath Gowri S.

Background: The objective of the present study was to observe the post void residual volume (PVRV) in women with pelvic organ prolapse (POP) pre and postoperatively and to correlate stage of prolapse with lower urinary tract symptoms and quality of life in women with pelvic organ prolapse.Methods: This is a prospective observational cohort study of 100 women with symptomatic pelvic organ prolapse of stage II or greater. Patients were admitted for Vaginal hysterectomy with pelvic floor repair for pelvic organ prolapse in Gynaecology Department at Christian Medical College Hospital, Vellore, India over one year were recruited. This study was approved by the institutional review board and ethical committee of the hospital. Pre- and post-operative PVR were measured. The statistical analysis was done by using SPSS version 21 and P value < 0.05 was considered as statistically significant.Results: In this study 100 patients were recruited and 11% of women had pre-operative high post void residual volume of more than 100 ml. Stages of POP did not correlate with severity of LUTS and QOL. Pre-operative elevated PVR resolved post operatively in 91%, the P value <0.000 which was highly significant.Conclusions: 11% of women had preoperative high PVR. Stages of POP did not correlate with severity of lower urinary tract symptoms (LUTS) and quality of life(QOL). Pre-operative elevated PVR resolved post operatively in 91%, the P value < 0.000 which was highly significant. Majority of the patient with severe pelvic organ prolapse had elevated pre-op PVR which resolved post- operatively after surgical correction.


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