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

Ingrid Nygaard1, Karl Kreder, Elizabeth Mueller

  • 1Department of Obstetrics and Gynecology, University of Utah College of Medicine, Salt Lake City, UT 84132, USA. Ingrid.nygaard@hsc.utah.edu

Neurourology and Urodynamics
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PubMed
Summary

Women with pelvic organ prolapse (POP) often experience urodynamic obstruction and urinary retention, regardless of continence. Symptoms of these conditions do not reliably predict urodynamic findings in POP patients.

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Area of Science:

  • Urogynecology
  • Pelvic Floor Disorders
  • Female Urology

Background:

  • Pelvic organ prolapse (POP) affects a significant number of women, often coexisting with lower urinary tract symptoms.
  • Urodynamic assessment is crucial for evaluating voiding dysfunction in women with POP.
  • The relationship between symptoms, urethral competence, and urodynamic findings in POP requires further clarification.

Purpose of the Study:

  • To compare voiding parameters in women with POP and varying degrees of urethral competence.
  • To correlate patient-reported symptoms with objective urodynamic findings in women with POP.

Main Methods:

  • Three groups of women with stages II-IV POP were compared.
  • Groups included continent women without (Group 1) and with (Group 2) urodynamic stress incontinence during prolapse reduction, and women with stress urinary incontinence symptoms (Group 3).
  • Standardized uroflowmetry, pressure-voiding studies, and validated symptom questionnaires were utilized.

Main Results:

  • 60% of all women were urodynamically obstructed.
  • Detrusor overactivity and detrusor overactivity incontinence were more prevalent in women with stress incontinence (Groups 2 and 3) compared to continent women (Group 1).
  • Voiding parameters, obstruction, and urinary retention did not differ significantly between groups, but Group 3 reported higher obstructive and irritative symptom scores.

Conclusions:

  • Women with POP exhibit high rates of urodynamic obstruction and urinary retention, irrespective of their continence status.
  • Patient-reported symptoms of obstruction and retention show a poor correlation with urodynamic findings in this population.
  • Urodynamic evaluation is essential for accurate diagnosis of voiding dysfunction in women with POP.