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Coexisting overactive-underactive bladder and detrusor overactivity-underactivity in pelvic organ prolapse
Matteo Frigerio1,2, Marta Barba1,2, Alice Cola1,2
1Department of Obstetrics and Gynecology, ASST Monza, Ospedale San Gerardo, Monza, Italy.
Summary
Pelvic organ prolapse (POP) surgery significantly improves coexisting overactive-underactive bladder (COUB) symptoms. Low opening detrusor pressure is a key predictor of persistent COUB after POP repair.
Area of Science:
- Urology
- Gynecology
- Pelvic Floor Disorders
Background:
- Coexisting overactive-underactive bladder (COUB) syndrome may stem from increased urethral resistance due to severe pelvic organ prolapse (POP).
- Understanding the relationship between POP and COUB is crucial for effective surgical management.
Purpose of the Study:
- To evaluate clinical and urodynamic findings in patients with COUB and/or detrusor overactivity-underactivity (DOU) undergoing POP surgery.
- To identify risk factors for COUB development or persistence after POP repair.
Main Methods:
- Retrospective analysis of 533 women undergoing POP repair (2008-2013).
- Patients classified as COUB or non-COUB based on symptoms, and DOU or non-DOU based on urodynamics.
- Multivariate analysis to determine predictors of postoperative COUB.
Main Results:
- Preoperatively, COUB patients exhibited more severe anterior compartment prolapse and higher rates of overactive bladder.
- POP surgery led to a significant reduction in COUB symptoms.
- Low preoperative opening detrusor pressure was the sole independent predictor of postoperative COUB.
Conclusions:
- Pelvic organ prolapse serves as a significant contributing factor to the development of COUB.
- POP repair effectively alleviates COUB symptoms.
- Opening detrusor pressure is a critical urodynamic parameter for predicting outcomes in COUB patients post-surgery.
Keywords:
coexistent detrusor overactivity-underactivitycoexistent overactive-underactive bladderpelvic organ prolapsesurgeryunderactive bladderurodynamicsMore Related Videos
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