Hydronephrosis and pelvic organ prolapse

To determine the prevalence of hydronephrosis in a cohort of women who had undergone surgery for pelvic organ prolapse (POP).

This observational, retrospective survey was conducted from January 2000 to December 2007 on 257 consecutive candidates for vaginal or abdominal surgical repair of POP (grade >2). In all patients, a standard clinical and instrumental urogynecologic workup was followed by POP repair. Follow-up visits were scheduled at 3, 6, and 9 months postoperatively and then annually.

Preoperative hydronephrosis was found in 13 patients (5%) with a mean age of 69.2 +/- 6.6 years. It was moderate in 5 and severe in 8; bilateral in 8 (3.1%), monolateral in 5 (1.9%); and POP-related in 9 cases. Surgical POP repair resolved the prolapse all patients and cured the ureterohydronephrosis in 7, with moderate ectasia of the upper urinary tract persisting in 2. The renal function at diagnosis was normal in 12 of 13 patients with hydronephrosis (mean 113 +/- 15 micromol/L); 1 patient had a high serum creatinine concentration (220 micromol/L). No patient developed renal failure during a mean follow-up of 43.5 months.

The prevalence of hydronephrosis was low in patients with POP who were candidates for surgery. POP repair usually resolves prolapse-related hydronephrosis and prevents serious long-term complications.