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The effect of prolapse surgery on voiding function.

Sascha Vereeck1,2,3, Stefaan Pacquée4, Stefan De Wachter5,6

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PubMed
Summary

Pelvic organ prolapse surgery significantly reduces voiding dysfunction symptoms and improves urinary flow rates and post-void residual urine. This study confirms the positive impact of prolapse repair on bladder function.

Keywords:
ImagingPelvic floor surgeryPelvic organ prolapseUroflowmetryVoiding dysfunction

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Area of Science:

  • Urology
  • Gynecology
  • Pelvic Floor Disorders

Background:

  • Symptomatic pelvic organ prolapse (POP) affects a significant number of women.
  • Voiding dysfunction (VD) is a common comorbidity in women with POP, impacting quality of life.

Purpose of the Study:

  • To evaluate the effect of pelvic organ prolapse surgery on voiding function in women.
  • To assess changes in VD symptoms, maximum urinary flow rate (MFR), and post-void residual urine (PVR) after prolapse repair.

Main Methods:

  • Retrospective analysis of 311 women undergoing POP surgery.
  • Standardized interviews, Pelvic Organ Prolapse Quantification (POP-Q), uroflowmetry, and 3D/4D transperineal ultrasound (TPUS) were used pre- and postoperatively.
  • Primary outcome: change in VD symptoms; Secondary outcomes: changes in MFR centile and PVR.

Main Results:

  • Preoperative VD symptoms were reported by 43.3% of women, decreasing to 22.2% postoperatively (p < 0.001).
  • A significant decrease in mean PVR was observed postoperatively (p < 0.001).
  • Excluding mid-urethral sling procedures, a significant increase in mean MFR centile was noted (p = 0.046).

Conclusions:

  • Pelvic organ prolapse surgery is effective in reducing symptoms of voiding dysfunction.
  • Surgical repair improves key parameters of bladder function, including PVR and MFR.
  • These findings support prolapse surgery as a treatment option for women experiencing concurrent VD.