Straining to void at preoperative urodynamic study as a risk factor for prolapse recurrence after surgery

Area of Science:

• Urogynecology
• Pelvic Floor Disorders
• Surgical Outcomes

Background:

• Straining to void involves increased abdominal pressure during bladder emptying, often seen in women with pelvic organ prolapse (POP) causing urinary obstruction.
• Frequent straining is a risk factor for developing POP and may contribute to recurrence after surgical repair.

Purpose of the Study:

• To investigate the association between preoperative straining identified during urodynamic studies and the recurrence of pelvic organ prolapse after surgical repair.

Main Methods:

• Retrospective study of women undergoing POP repair (vaginal hysterectomy with modified McCall culdoplasty and anterior colporraphy).
• Preoperative urodynamic evaluation including pressure-flow studies with prolapse reduction via pessary.
• Patients categorized based on the presence or absence of straining during voiding; surgical outcomes and recurrence rates at 12 months were compared.

Main Results:

• Women with straining exhibited a significantly higher risk of anterior POP recurrence (Stage II and III) compared to those without straining.
• No significant difference in central recurrence rates was observed between the groups.
• POP-Q staging at 12 months showed a better outcome for the Aa point location in women without straining.

Conclusions:

• Preoperative identification of straining to void during urodynamic studies is a potential predictor of increased risk for anterior pelvic organ prolapse recurrence after surgical intervention.