Does urethral competence affect urodynamic voiding parameters in women with prolapse?

Ingrid Nygaard; Karl Kreder; Elizabeth Mueller; Linda Brubaker; Patricia Goode; Anthony Visco; Anne M. Weber; Geoff Cundiff; John Wei; Pelvic Floor Disorders Network

doi:10.1002/nau.20436

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Does urethral competence affect urodynamic voiding parameters in women with prolapse?

Journal article

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Does urethral competence affect urodynamic voiding parameters in women with prolapse?

Ingrid Nygaard, Karl Kreder, Elizabeth Mueller, Linda Brubaker, Patricia Goode, Anthony Visco, Anne M. Weber, Geoff Cundiff, John Wei and Pelvic Floor Disorders Network

Neurourology and urodynamics, Vol.26(7), pp.1030-1035

01/01/2007

DOI: 10.1002/nau.20436

PMID: 17638306

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Abstract

Aims: To (1) compare voiding parameters and (2) correlate symptoms and urodynamic findings in women with pelvic organ prolapse (POP) and varying degrees of urethral competence. Methods: We compared three groups of women with stages H-IV POP. Groups 1 and 2 were symptomatically stress continent women participating in the Colpopexy and Urinary Reduction Efforts (CARE) trial; during prolapse reduction before sacrocolpopexy, Group 1 (n = 67) did not have and Group 2 (n = 84) had urodynamic stress incontinence (USI) during prolapse reduction. Group 3 participants (n = 74), recruited specifically for this study, had stress urinary incontinence (SUI) symptoms and planned sacrocolpopexy. Participants completed standardized uroflowmetry, pressure voiding studies, and validated symptom questionnaires. Results: Subjects' median age was 61 years, median parity 3 and 87% had stage III or IV POP. Fourteen percent of women in Group 3 demonstrated USI without, and 70% with, prolapse reduction. Women in Groups 2 and 3 had more detrusor overactivity (DO) than Group 1 (17 and 24% vs. 6%, P= 0.02) and detrusor overactivity incontinence (DOI) (15 and 8% vs. 0%, P = 0.004). Based on the Blaivis-Groutz nomogram, 60% of all women were obstructed. Post-void residual volume (PVR), peak flow rate, detrusor pressure at peak flow, voiding mechanisms, voiding patterns, obstruction and urinary retention did not differ among groups. Women in Group 3 had higher irritative and obstructive symptom scores than Group 1 or 2; neither score differed by presence of DO nor obstruction, respectively. Conclusion: Women with POP have significant rates of urodynamic obstruction and retention, independent of their continence status. Symptoms of obstruction and retention correlate poorly with urodynamic findings. © 2007 Wiley-Liss, Inc.

obstruction

pelvic organ prolapse

urodynamics

voiding

Details

Title: Subtitle: Does urethral competence affect urodynamic voiding parameters in women with prolapse?
Creators: Ingrid Nygaard - University of Utah
Karl Kreder - University of Iowa
Elizabeth Mueller - Loyola University Medical Center
Linda Brubaker - Loyola University Medical Center
Patricia Goode - University of Alabama at Birmingham
Anthony Visco - University of North Carolina at Chapel Hill
Anne M. Weber - Eunice Kennedy Shriver National Institute of Child Health and Human Development
Geoff Cundiff - University of British Columbia
John Wei - University of Michigan
Pelvic Floor Disorders Network
Resource Type: Journal article
Publication Details: Neurourology and urodynamics, Vol.26(7), pp.1030-1035
DOI: 10.1002/nau.20436
PMID: 17638306
NLM abbreviation: Neurourol Urodyn
ISSN: 0733-2467
eISSN: 1520-6777
Publisher: Wiley Subscription Services, Inc., A Wiley Company
Number of pages: 6
Language: English
Date published: 01/01/2007
Academic Unit: Obstetrics and Gynecology; Urology
Record Identifier: 9984383298002771

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