For a study, researchers sought to determine whether lower urinary tract symptoms (LUTS) and urodynamic data correlate before and after surgical therapy for pelvic organ prolapse (POP).
In the prospective analysis, 74 patients with stage II or higher anterior POP associated with LUTS and qualified for surgical POP correction were enrolled. Before and 6 months following the surgical correction of POP, all patients underwent urodynamic testing (UDS) and clinical assessment.
The average age was 45±9 years. BMI was 28 kg/m2 on average. Most cases had an associated apical prolapse (37/74, 50%), stage III cystocele (50/74, 68%) and were multiparous. For overt (26/74, 35%) or occult (15/74, 20%) stress urinary incontinence, native tissue repair was performed in 53/74 (72%) patients with a concurrent anti-incontinence operation in 41/74 (55%) of the cases (SUI). Preoperative UDS showed obstruction of the detrusor pressure at a maximal flow rate in 20/26 (77%) patients with voiding LUTS and detrusor overactivity (DO) in 19/56 (34%) patients who presented with storage LUTS. At the 6-month follow-up, 61/74 (82%) patients had significantly improved LUTS, 39/41 (95%) patients had SUI resolve, and 1/33 (3%) patients had developed de novo SUI. There was no correlation between preoperative DO and post-void residual urine volume and surgical improvement or persistence of LUTS. Detrusor underactivity was seen in 4 individuals with persistent LUTS on both preoperative and postoperative UDS.
After POP surgery, patients’ LUTS significantly improved, whether or not they underwent an anti-incontinence operation. However, the persistence of voiding LUTS was linked to detrusor underactivity. Meanwhile, preoperative DO and post-void residual urine volume had no predictive value.