Abstract
Introduction and hypothesis
This study evaluates the effect of baseline pelvic organ prolapse (POP) severity on improvement in overactive bladder (OAB) symptoms after pelvic reconstructive surgery.
Methods
We performed a retrospective cohort study of women with POP and OAB who underwent surgical correction of symptomatic apical and/or anterior POP. OAB was defined as an affirmative response to item #15 (urinary frequency) and/or item #16 (urge incontinence) of the Pelvic Floor Distress Inventory (PFDI). POP severity was dichotomized as Pelvic Organ Prolapse Quantification (POP-Q) stage 1–2 versus stage 3–4. Our primary outcome was complete resolution or improvement of urinary frequency or urge incontinence on the PFDI 12 months postoperatively.
Results
At 12 months postoperative, 41 (89%) women with stage 1–2 POP versus 47 (85 %) with stage 3–4 POP reported improvement in urinary frequency (p = 0.58). Thirty five (90 %) with stage 1–2 and 34 (85 %) with stage 3–4 POP reported improvement in urge incontinence (p = 0.74). On multiple logistic regression, women with stage 3–4 POP had a decreased odds of improvement in frequency or urge incontinence compared with women with stage 1–2 POP (adjusted odds ration [AOR] = 0.06 [95 % CI 0.01–0.67]), after adjusting for confounders.
Conclusions
Women with coexisting POP and OAB who undergo surgical correction of POP experience improvement in OAB symptoms after surgery, although women with more severe POP may be at a higher risk of persistent frequency or urge incontinence.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Digesu GA, Chaliha C, Salvatore S, Hutchings A, Khullar V (2005) The relationship of vaginal prolapse severity to symptoms and quality of life. BJOG 112:971–976
Smith FJ, Holman CD, Moorin RE, Tsokos N (2010) Lifetime risk of undergoing surgery for pelvic organ prolapse. Obstet Gynecol 116(5):1096–1100
Jelovsek J, Barber M (2006) Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol 194:1455–1461
Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Victor A, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the standardisation subcommittee of the international continence society. Neurourol Urodyn 21:167–178
Temml C, Heidler S, Ponholzer A, Madersbacher S (2005) Prevalence of the overactive bladder syndrome by applying the International Continence Society definition. Eur Urol 48:622–627
Ganz ML, Smalarz AM, Krupski TL, Anger JT, Hu JC, Wittrup-Jensen KU, Pashos CL (2010) Economic costs of overactive bladder in the United States. Urology 75(3):526–532
Clemons JL, Aguilar VC, Tillinghast TA, Jackson ND, Myers DL (2004) Patient satisfaction and changes in prolapse and urinary symptoms in women who were fitted successfully with a pessary for pelvic organ prolapse. Am J Obstet Gynecol 190:1025–1029
Fernando RJ, Thakar R, Sultan AH, Shah SM, Jones PW (2006) Effect of vaginal pessaries on symptoms associated with pelvic organ prolapse. Obstet Gynecol 108:93–99
Nguyen JK, Bhatia NN (2001) Resolution of motor urge incontinence after surgical repair of pelvic organ prolapse. J Urol 166:2263–2266
Digesu GA, Salvatore S, Chaliha C, Athanasiou S, Milani R, Khullar V (2007) Do overactive bladder symptoms improve after repair of anterior vaginal wall prolapse? Int Urogynecol J Pelvic Floor Dysfunct 18:1439–1443
Okui N, Okui M, Horie S (2009) Improvements in overactive bladder syndrome after polypropylene mesh surgery for cystocele. Aust N Z J Obstet Gynaecol 49:226–231
Foster RT Sr, Barber MD, Parsio MFR, Walters MD, Weidner AC, Amundsen CL (2007) A prospective assessment of overactive bladder symptoms in a cohort of elderly women who underwent transvaginal surgery for advanced pelvic organ prolapse. Am J Obstet Gynecol 197:82.e1–82.e4
Barber MD, Walters MD, Bump RC (2005) Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 193:103–113
Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JOL, Klarskov P, Shull BL, Smith ARB (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17
Fletcher SG, Haverkorn RM, Yan J, Lee JL, Zimmern PE, Lemack GE (2010) Demographic and urodynamic factors associated with persistent OAB after anterior compartment prolapse repair. Neurourol Urodyn 29:114–1418
De Boer TA, Kluivers KB, Withagen M, Milani AL, Vierhout ME (2010) Predictive factors for overactive bladder symptoms after pelvic organ prolapse surgery. Int Urogynecol J 21:1143–1149
Romanzi LJ, Chaikin DC, Blaivas JG (1999) The effect of genital prolapse on voiding. J Urol 161:581–586
Long CY, Hsu CS, Wu MP, Liu CM, Chiang PH, Juan YS, Tsai EM (2011) Predictors of improved overactive bladder symptoms after transvaginal mesh repair for the treatment of pelvic organ prolapse. Int Urogynecol J 22:535–542
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Miranne, J.M., Lopes, V., Carberry, C.L. et al. The effect of pelvic organ prolapse severity on improvement in overactive bladder symptoms after pelvic reconstructive surgery. Int Urogynecol J 24, 1303–1308 (2013). https://doi.org/10.1007/s00192-012-2000-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00192-012-2000-z