Detrusor underactivity in pelvic organ prolapse

Area of Science:

• Urology
• Gynecology
• Pelvic Floor Disorders

Background:

• The relationship between pelvic organ prolapse (POP) and detrusor underactivity (DU) requires further clarification.
• Understanding DU prevalence in POP patients is crucial for effective management and treatment outcomes.

Purpose of the Study:

• To determine the prevalence of DU in patients with POP.
• To investigate the association of DU with symptoms, anatomical findings, and urodynamic results.
• To evaluate lower urinary tract symptom evolution post-POP repair in DU versus non-DU patients.

Main Methods:

• Retrospective analysis of 518 patients undergoing preoperative urodynamic testing.
• Detrusor underactivity diagnosed using the Bladder Contractility Index (BCI < 100).
• Patients categorized into Group A (DU) and Group B (non-DU) for comparative analysis.

Main Results:

• DU was identified in 40.9% of POP patients (Group A).
• Group A exhibited higher rates of voiding symptoms and post-void residual, with lower rates of urge incontinence and detrusor overactivity.
• Greater severity of cystocele (Aa and Ba points) was observed in Group A; postoperative voiding symptoms were similar after POP repair.

Conclusions:

• A significant prevalence of DU exists in POP patients, linked to voiding dysfunction and anatomical prolapse severity.
• Surgical correction of POP may alleviate or resolve voiding symptoms in patients with DU, suggesting mechanical obstruction plays a role.
• These findings highlight the importance of assessing DU in POP patients and considering its impact on surgical outcomes.