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Female pelvic organ prolapse and voiding function.

H P Dietz1, B T Haylen, T G Vancaillie

  • 1Royal Prince Alfred Hospital and University of New South Wales, Sydney. hpdietz@bigpond.com

International Urogynecology Journal and Pelvic Floor Dysfunction
|October 2, 2002
PubMed
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Pelvic organ prolapse impacts bladder emptying, with enterocele consistently worsening flow. Anterior wall prolapse effects on voiding are complex, with some types improving flow while others worsen it.

Area of Science:

  • Urogynecology
  • Pelvic Floor Disorders
  • Lower Urinary Tract Dysfunction

Background:

  • Pelvic organ prolapse (POP) is known to affect voiding, particularly anterior vaginal wall prolapse.
  • The impact of central and posterior prolapse on bladder emptying remains debated.
  • Mechanical factors like urethral distortion and compression are hypothesized causes.

Purpose of the Study:

  • To investigate the relationship between different types of pelvic organ prolapse and lower urinary tract symptoms (LUTS).
  • To clarify the mechanical effects of POP on voiding function.
  • To determine which specific prolapse types negatively influence urinary flow.

Main Methods:

  • A study of 228 patients with LUTS and/or POP.
  • Utilized independent flowmetry, clinical assessment, International Continence Society (ICS) prolapse staging, and translabial ultrasound.

Related Experiment Videos

  • Correlated patient data with voiding parameters.

    • Main Results:

    • Age, prior hysterectomy, and previous incontinence surgery were associated with impaired flow.
    • Enterocele demonstrated a consistent negative impact on urinary flow across all assessment methods (clinical, ICS, ultrasound).
    • Anterior vaginal wall prolapse showed complex effects: retrovesical angle funneling/opening improved flow, whereas cystocele with an intact retrovesical angle worsened it.

    Conclusions:

    • Enterocele is significantly associated with impaired voiding.
    • The effect of anterior vaginal wall prolapse on voiding is nuanced and depends on specific anatomical changes.
    • Understanding these relationships is crucial for managing patients with POP and LUTS.